# Adults with non-specific neck pain - Savonia AMK

> Neck pain is a common complaint, and in most cases, it is non-specific or benign, with a good prognosis for recovery.

## Background
This article is part of a series produced within the course *Professional in Physiotherapy* at Savonia University of Applied Sciences. It was created as part of the evidence-based physiotherapy section of the course, where students practiced systematic literature review methods, including information retrieval and critical appraisal using the PEDro Scale.

Neck pain is the fourth most common musculoskeletal disorder globally. While most cases are non-specific or benign, serious conditions must always be excluded. Common causes include muscle tension resulting from physical or mental strain, with risk factors including age, female gender, overweight, and previous episodes of neck pain.

## Research Objective
The aim of this review is to investigate the effectiveness of physiotherapy interventions in adults with non-specific neck pain. The research question, structured using the PICO framework, asks: In adults with non-specific neck pain (Population), do physiotherapy interventions such as therapeutic exercise, manual therapy, or exercise guidance (Intervention), compared to no treatment or other conservative approaches (Comparison), lead to a reduction in pain and improvement in function (Outcome)?

## Methodology
The review focused on randomized controlled trials (RCTs) published within the last five years. 
*   **Inclusion criteria:** Adults aged 18+, physiotherapy or exercise interventions, full-text articles available for free.
*   **Exclusion criteria:** Participants under 18, non-RCT studies, paywalled articles, and specific medical conditions (cancer, rheumatic diseases, neurological disorders, or acute trauma like fractures/whiplash).
*   **Quality assessment:** Methodological quality was assessed using the PEDro Scale.

## Findings
*   **Dalager et al. (2022):** High-quality, supervised training twice a week effectively reduces pain (PEDro score: 5/10).
*   **Johnston et al. (2021):** Combining ergonomics and exercise (EET) proved more effective in the short term than health counseling alone (PEDro score: 5/10).
*   **Kang and Kim (2022):** Resistance training (e.g., chin tucks and rowing) improved mobility and reduced stiffness/pain more effectively than trapezius muscle massage (PEDro score: 6/10).
*   **Bernal-Utrera et al. (2020):** Manual therapy provided faster pain relief, but therapeutic exercise led to greater long-term improvements in functional capacity (PEDro score: 6/10).

## Conclusion
The evidence highlights the central role of targeted exercise in managing chronic and recurrent neck pain. While manual or passive therapies may offer short-term relief, long-term benefits are most consistently linked to structured, active exercise interventions. Prioritizing active rehabilitation—such as strength and resistance training—is recommended for both clinical practice and workplace health strategies.

## Authors
*   Ira Väänänen, physiotherapy student, Savonia University of Applied Sciences
*   Juuli Grenfors, physiotherapy student, Savonia University of Applied Sciences
*   Martta Kellosaari, physiotherapy student, Savonia University of Applied Sciences
*   Lilli Taskinen, physiotherapy student, Savonia University of Applied Sciences
*   Marja Äijö PT, PhD, Principal lecturer of Gerontology and Rehabilitation, Savonia University of Applied Sciences

## References
*   Bernal-Utrera, C., Gonzalez-Gerez, J. J., Anarte-Lazo, E., & Rodriguez-Blanco, C. (2020). Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials, 21(1), 682. https://doi.org/10.1186/s13063-020-04610-w
*   Dalager, T., Welch, A., O’Leary, S.P., Johnston, V., & Sjogaard, G. (2022). Clinically relevant decreases in neck/shoulder pain among office workers are associated with strength training adherence and exercise compliance: Explorative analyses from a randomized controlled trial. Physical Therapy. https://doi.org/10.1093/ptj/pzac166
*   Dickerman, R. (2018). Physical Therapy for Neck Pain Relief. Spine-health.com.
*   Johnston, V., Chen, X., Welch, A., Sjøgaard, G., Comans, T. A., McStea, M., Straker, L., Melloh, M., Pereira, M., & O’Leary, S. (2021). A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain – a secondary outcome analysis. BMC Musculoskeletal Disorders, 22, 945. https://doi.org/10.1186/s12891-021-03945-y
*   Saarelma, O. (2021). Niskakipu. Terveyskirjasto.fi.
*   Suomalaisen Lääkäriseuran Duodecimin, Societas Medicinae Physicalis et Rehabilitationis Fenniae ry:n ja Suomen Yleislääketieteen yhdistyksen asettama työryhmä. (2017). Niskakipu (aikuiset). Käypä hoito –suositus. Helsinki: Suomalainen Lääkäriseura Duodecim.
*   Taewoo, K., & Beomryong, K. (2022). Cervical and scapula-focused resistance exercise program versus trapezius massage in patients with chronic neck pain: A randomized controlled trial. Medicine. https://doi.org/10.1097/MD.0000000000030887
*   Verhage, A.P. (2020). Physiotherapy management of neck pain. Journal of Physiotherapy, 67, 5–11. https://doi.org/10.1016/j.jphys.2020.12.005