National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Per Kjaer^{1

2}, Alice Kongsted^{3

4

5}, Jan Hartvigsen^{3

5}, Alexander Isenberg-Jørgensen⁶, Berit Schiøttz-Christensen^{7

8}, Bolette Søborg⁴, Charlotte Krog⁹, Christian Martin Møller¹⁰, Christine Marie Bækø Halling^{4

11}, Henrik Hein Lauridsen³, Inge Ris Hansen³, Jesper Nørregaard¹², Karsten Juhl Jørgensen^{4

13}, Lars Valentin Hansen¹⁴, Marie Jakobsen^{4

11}, Martin Bach Jensen¹⁵, Martin Melbye¹⁶, Peter Duel¹⁷, Steffan W Christensen^{18

19}, Tina Myung Povlsen^{4

20}

Affiliations

¹ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. pkjaer@health.sdu.dk.
² Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark. pkjaer@health.sdu.dk.
³ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
⁴ Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.
⁵ Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
⁶ Centre for Spine Surgery and Research, Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark.
⁷ Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark.
⁸ Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, Odense M, Denmark.
⁹ Københavns Fysioterapi I/S, J. E. Ohlsens Gade 2, 1, th, 2100, København Ø, Denmark.
¹⁰ CFR Hospitaler, Hans Bekkevolds Allé 2B, 2900, Hellerup, Denmark.
¹¹ KORA, the Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark.
¹² Centre for Rheumatology and Spine Diseases, Dyrehavevej 29, 3400, Hillerød, Denmark.
¹³ The Nordic Cochrane Centre, Rigshospitalet, 7811, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
¹⁴ Spine Unit, Department of Ortopaedic Surgery, Rigshospitalet, Copenhagen, Denmark.
¹⁵ Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Fyrkildevej 7,1, 9220, Aalborg Ø, Denmark.
¹⁶ Aalborg Spine Clinic, Aalborg Rygklinik, Vingaardsgade 9, 9000, Aalborg, Denmark.
¹⁷ Neurosurgical Department, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus C, Denmark.
¹⁸ Department of Health Science and Technology, SMI®, Aalborg University, Aalborg, Denmark.
¹⁹ Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark.
²⁰ Research and Test Center for Health Technologies. Rigshospitalet, Nordre Ringvej 57. Opgang 8, 5.sal., 2600, Glostrup, Denmark.

PMID: 28523381
DOI: 10.1007/s00586-017-5121-8

Review

National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Per Kjaer et al. Eur Spine J. 2017 Sep.

. 2017 Sep;26(9):2242-2257.

doi: 10.1007/s00586-017-5121-8. Epub 2017 May 18.

Authors

Affiliations

¹ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. pkjaer@health.sdu.dk.
² Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark. pkjaer@health.sdu.dk.
³ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
⁴ Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.
⁵ Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
⁶ Centre for Spine Surgery and Research, Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark.
⁷ Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark.
⁸ Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, Odense M, Denmark.
⁹ Københavns Fysioterapi I/S, J. E. Ohlsens Gade 2, 1, th, 2100, København Ø, Denmark.
¹⁰ CFR Hospitaler, Hans Bekkevolds Allé 2B, 2900, Hellerup, Denmark.
¹¹ KORA, the Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark.
¹² Centre for Rheumatology and Spine Diseases, Dyrehavevej 29, 3400, Hillerød, Denmark.
¹³ The Nordic Cochrane Centre, Rigshospitalet, 7811, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
¹⁴ Spine Unit, Department of Ortopaedic Surgery, Rigshospitalet, Copenhagen, Denmark.
¹⁵ Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Fyrkildevej 7,1, 9220, Aalborg Ø, Denmark.
¹⁶ Aalborg Spine Clinic, Aalborg Rygklinik, Vingaardsgade 9, 9000, Aalborg, Denmark.
¹⁷ Neurosurgical Department, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus C, Denmark.
¹⁸ Department of Health Science and Technology, SMI®, Aalborg University, Aalborg, Denmark.
¹⁹ Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark.
²⁰ Research and Test Center for Health Technologies. Rigshospitalet, Nordre Ringvej 57. Opgang 8, 5.sal., 2600, Glostrup, Denmark.

PMID: 28523381
DOI: 10.1007/s00586-017-5121-8

Abstract

Purpose: To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority.

Methods: Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

Results: Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy; combinations of exercise and manual therapy before medicine for NP; acupuncture for NP but not CR; traction for CR; and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR.

Conclusion: Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.

Keywords: Cervical radiculopathy; Clinical guideline; Conservative treatment; Neck pain; Non-surgical intervention; Recommendations.

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References

1. CMAJ. 2010 Dec 14;182(18):E839-42 - PubMed
1. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):783-92 - PubMed
1. Spine (Phila Pa 1976). 2009 Jan 15;34(2):206-13 - PubMed
1. Clin J Pain. 2015 Feb;31(2):133-6 - PubMed
1. Brain. 1994 Apr;117 ( Pt 2):325-35 - PubMed

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National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Affiliations

National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous