How Effective are The Available Treatments for Mechanical Neck Disorder?  

Oleh:

Ferrari, Robert R. ; Russell, Anthony S.

Jenis: Article from Bulletin/Magazine - ilmiah internasional
Dalam koleksi: Medical Progress vol. 35 no. 01 (Jan. 2008), page 5.

Ketersediaan

Perpustakaan FK Nomor Panggil: M36.K.2008.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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OBJECTIVE : To determine how effective the available therapies are for treatment of mechanical neck disorder (MND). DESIGN : this was a systemetic review of medical and alternative-medicine literature published between 1997 and September 2004. Clinical papers were identified using terms related to ánatomic', 'disorder/syndrome', 'treatment' and 'methodology'. RESULT : Strong evidence was not for long term (=1 year) reduction of pain, improvement of function and favourable global perceived effect (GPE) for multimodel approaches, including stretching and/or strengthening exercise, and mobilization and/or manipulation, in patients with subacute and chronic MND, NDH and NDR. Although moderate evidence was found for intermediate and long-term benefit of stretching and strengthening exercise alone, exercise involving the shoulder region only, with general conditioning, had no effect on pain but did result in short term improvement in function for patients with chronic MND. Moderate evidence was also found for the use of low level laser therapy for intermediate term (=3 months to <1 yera) pain reduction and functional improvement for patients with MND, and for the use of short-course electrotherapy, which involves low-frequency pulsed elctromagnetic field, for post treatment (=1 day) amelioration of pain in patients with whiplash-associated disorders, acute MND or chronic MND with associated degenerative changes. Moderate evidence was also noted for both intermittent traction and acupunture, which provided short term (>1 dat to <3 months) reduction of pain for patients with chronic MND and NDR. Limited evidence was found for beneficial effects of repetitive magnetic stimulation, traditional Chinese massage, orthopaedic, pillow and intramuscullar injection of lidocain. No intermediate or long term benefitof home exercise, hot packs, electromechanical stimulation, ultrasound, or combination of manipulation, mobilization or modalities, was observed for pain or function in patients with MND. No short term reduction of pain was observed after a variety of treatments, including : botulinum-A toxin, morphine added to epidural injection, manipulation alone, massage therapies, electrotherapies, infrared light, static traction, spray and stretch, ultra reiz, oral splint, neck school, various type of advice, and laser therapy for myofascial pain. CONCLUSION : Modest advances have been made towards the understanding of how effective available therapies are for treating MND; further information is needed regarding the effectiveness of commonly-used pain medications, and the most effective therapies or combinations thereof as well as optimal dosage.

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