Active or passive treatment for neck-shoulder pain in occupational health care? A randomized controlled trial

Abstract

Background. Neck-shoulder pain is a common complaint, with high lifetime prevalence. However, there is substantial disagreement regarding the most effective treatment methods. Aims. To compare the effectiveness of thoracic manipulations with instructions for physiotherapeutic exercises for the treatment of neck pain in occupational health care. Methods. Seventy-five subjects aged 30-55 years from a random sample of 241 employees of the Finnish Broadcasting Company werc randomly allocated to treatment in the form of four thoracic manipulations (n = 43), or instructions for physiotherapeutic exercises (n = 32). The subjects reported neck-shoulder pain on a structured pain questionnaire using a visual analogue scale (VAS, 0-10). Muscle tenderness and tender thoracic levels were evaluated by a blinded investigator (A.S.) at 6- and 12 month follow-ups. Results. A statistically significant difference was found in self-reported worst pain by VAS at the 12 month follow-up in favour of the thoracic manipulation group. Conclusions. The natural course of the neck-shoulder pain in this study appears benign; pain was also reduced in the drop-out group. Both treatments were found effective at the 12 month follow-up. The effect of four manipulations was more favourable than the personal exercise program in treating the more intense phase of pain. © Society of Occupational Medicine 2004; all rights reserved.