Effective Strategies for Patients with Uncomplicated Neck Pain

Estimates suggest over 70% of people in the US are affected by neck pain at some time in their lives. Neck pain can be severe enough to negatively impact quality of life and the ability to work. However, little research has been conducted on the comparative effectiveness of different treatment options. A research study conducted by Bronfort and colleagues focused on changes in acute and subacute neck pain in response to 3 different treatments:

  1. Chiropractic care including spinal manipulation, advice to stay active or modify activity, and adjunct therapy as needed
  2. Medication: non-steroidal anti-inflammatory drugs, acetaminophen, or narcotics for those who could not tolerate first-line therapy, and advice to stay active or modify activity as needed
  3. Home exercise with two separate one-hour instructional sessions including anatomy instruction, practical demonstrations of common movements, postural instructions and other advice with a trained provider and individualized to each participants ability and tolerance


After 12 weeks of treatment and then by following study participants for up to one year, the authors

  • Neck pain was significantly less in both the spinal manipulation therapy and home exercise with professional instruction groups when compared with the medication group at 12 weeks, 6 months, and one year time points.
  • Changes in neck pain were approximately the same for both chiropractic and home exercise with professional instruction groups throughout the entire study.
  • Home exercise with professional instruction groups appeared to be the least expensive treatment.

Take-Home Message

Chiropractic treatment and home exercise with professional instruction groups were both more effective at treating neck pain than prescription medication in both the short and long-term. Home exercise with educational instruction from a trained provider was the least expensive treatment.

For more information regarding the home exercises provided to participants located in the article supplement, or to access the complete article go to: http://annals.ohttps://www.acpjournals.org/doi/10.7326/0003-4819-156-1-201201030-00002?articleid=1033256rg/article.aspx?articleid=1033256


Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain: A Randomized Trial. Ann Intern Med. 2012;156:1-10.