National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Eur Spine J. 2017 Sep;26(9):2242-2257. doi: 10.1007/s00586-017-5121-8. Epub 2017 May 18.

Abstract

Purpose: To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority.

Methods: Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

Results: Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy; combinations of exercise and manual therapy before medicine for NP; acupuncture for NP but not CR; traction for CR; and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR.

Conclusion: Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.

Keywords: Cervical radiculopathy; Clinical guideline; Conservative treatment; Neck pain; Non-surgical intervention; Recommendations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acupuncture Therapy / methods
  • Denmark
  • Exercise Therapy / methods
  • Humans
  • Massage / methods
  • Musculoskeletal Manipulations / methods
  • Neck Pain / therapy*
  • Pain Management / methods
  • Patient Education as Topic / methods
  • Practice Guidelines as Topic*
  • Radiculopathy / diagnosis*
  • Traction