The Clinical Compass has released new recommendations1 for the nondrug treatment of neck pain and whiplash disorders. The document summarizes a 16-point best-practice approach to neck pain and provides specifics regarding patient recovery / maximum therapeutic benefit; informed consent; red and yellow flags; pain parameters; diagnostic imaging guidelines for acute and chronic neck pain; treatment frequency and duration; passive modalities for acute and subacute neck pain and other clinical considerations. Examples of the 16-point best-practice approach include the following:
Reassure the patient regarding the generally benign nature of minor neck pain and encourage activity and movement. With moderate to severe neck pain, emphasize the importance of treatment plan compliance.
Begin treatment with a brief trial of care, 6 to 12 visits, followed by evaluation for treatment effectiveness. The initial trial is not the same as a limit or cap on care.
Refer patients with new or worsening symptoms or evidence of psychological issues to providers with expertise in those areas (eg, behavioral health).
"Developing a consistent approach to manage neck pain based on the best available evidence is important to providing optimal patient care," said Dr. Wayne Whalen, lead author of the recommendations. "The development of this best practices recommendation helps providers use approaches that yield clinically and cost-effective management of neck pain."2
The authors of the new recommendations, yielded following a modified Delphi consensus process conducted from August-November 2018, conclude: "These best-practice recommendations for chiropractic management of adults with neck pain are based on the best available scientific evidence. For uncomplicated neck pain, including neck pain with headache or radicular symptoms, chiropractic manipulation and multimodal care are recommended."
References
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