For persistent (>3 months) neck pain, we suggest offering multimodal care or stress self-management manipulation with soft tissue therapy high-dose massage supervised group exercise supervised yoga supervised strengthening exercises or home exercises (grades I-II NAD) multimodal care or practitioner's advice (grades I-III NAD) and supervised exercise with advice or advice alone (grades I-II WAD). The guideline was peer reviewed by a 10-member multidisciplinary (medical and chiropractic) external committee.įor recent-onset (0-3 months) neck pain, we suggest offering multimodal care manipulation or mobilization range-of-motion home exercise, or multimodal manual therapy (for grades I-II NAD) supervised graded strengthening exercise (grade III NAD) and multimodal care (grade III WAD). Consensus was achieved using a modified Delphi. The guideline panel considered the balance of desirable and undesirable consequences. ![]() ![]() Evidence profiles were used to summarize judgments of the evidence quality, detail relative and absolute effects, and link recommendations to the supporting evidence. We incorporated risk of bias scores in the Grading of Recommendations Assessment, Development, and Evaluation. Pertinent systematic reviews on 6 topic areas (education, multimodal care, exercise, work disability, manual therapy, passive modalities) were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and data extracted from admissible randomized controlled trials. This guideline replaces 2 prior chiropractic guidelines on NADs and WADs. The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders (NADs) and whiplash-associated disorders (WADs). 13 Health Systems Management, Rush University, Chicago, IL.12 Downsview Chiropractic, Toronto, ON, Canada.11 Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada.10 Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, MB, Canada.9 Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.8 University Health Network, Toronto Western Research Institute, University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada. ![]()
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