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Active treatment of chronic neck pain

Evidence Summaries

Level of Evidence = C

Active treatment consisting of proprioceptive training, relaxation and behavioural support may be more effective than home exercises or rest in chronic neck pain.

In a randomized comparative study with single-blind outcome assessments 1 the efficacy of a multimodal treatment emphasizing proprioceptive training (ACTIVE) was compared with activated home exercises (HOME) and recommendation of exercise (CONTROL) in patients with nonspecific chronic neck pain. Seventy-six patients (22 men, 54 women) with chronic, nonspecific neck pain participated. Sixty-two participated the 1-year follow-up. Subjective pain and disability, cervical ranges of motion, and pressure pain threshold in the shoulder region were measured at baseline, at 3 months, and at 12 months. The ACTIVE treatment consisted of 24 sessions of proprioceptive exercises, relaxation, and behavioral support. The HOME regimen included a neck lecture and two sessions of practical training for home exercises and instructions for maintaining a diary of progress. The CONTROL treatment included a lecture regarding care of the neck with a recommendation to exercise. The average self-experienced total benefit was highest in the ACTIVE group, and the HOME group rated over the CONTROL group (P < 0.001). Differences between the groups in favour of the ACTIVE treatment were recorded in reduction of neck symptoms and improvements in general health and self-experienced working ability (P < 0.01-0.03). Changes in measures of mobility and pressure pain threshold were minor.

Comment: The quality of evidence is downgraded by sparse data and indirectness of evidence; only subjective outcomes were improved.


1. Taimela S, Takala EP, Asklöf T, Seppälä K, Parviainen S. Active treatment of chronic neck pain: a prospective randomized intervention. Spine 2000 Apr 15;25(8):1021-7.  [PMID:10767816]

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"Active Treatment of Chronic Neck Pain." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/450450/all/Active_treatment_of_chronic_neck_pain.
Active treatment of chronic neck pain. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/450450/all/Active_treatment_of_chronic_neck_pain. Accessed August 18, 2019.
Active treatment of chronic neck pain. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/450450/all/Active_treatment_of_chronic_neck_pain
Active Treatment of Chronic Neck Pain [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 August 18]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/450450/all/Active_treatment_of_chronic_neck_pain.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Active treatment of chronic neck pain ID - 450450 BT - Evidence-Based Medicine Guidelines UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/450450/all/Active_treatment_of_chronic_neck_pain PB - Duodecim Medical Publications Limited DB - Evidence Central DP - Unbound Medicine ER -