Long-term strength training and stretching for chronic neck pain
One page on PainSci cites Häkkinen 2008: The Complete Guide to Neck Pain & Cricks
PainSci commentary on Häkkinen 2008: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Researchers tested the effectiveness of strength training for neck pain and disability by comparing two exercise regimens, kicked off with ten group training sessions. A hundred patients participated: fifty did a year of strength training combined with stretching, and the other fifty did just stretching. No significant differences were found in pain or disability.
The authors also noted that patient dedication to the exercises probably left something to be desired, but that’s so inevitable in any group of average people that it can be considered a natural weakness of exercise therapy. So this evidence strongly suggests that strengthening is unremarkable at best as a therapy for neck pain, either because it doesn’t work particularly well, and/or because you can’t get people to do it long enough and well enough even if it did.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain.
DESIGN: A randomized follow-up study.
PARTICIPANTS: One hundred and one patients with chronic non-specific neck pain were randomized in two groups.
INTERVENTION: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session.
MAIN OUTCOME MEASUREMENTS: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention.
RESULTS: No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P<0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group.
CONCLUSIONS: No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.
related content
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” Nikander et al, Medicine & Science in Sports & Exercise, 2006.
- “Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial,” Ylinen et al, Journal of Rehabilitation Medicine, 2007.
- “Effect of neck exercises on cervicogenic headache: a randomized controlled trial,” Ylinen et al, Journal of Rehabilitation Medicine, 2010.
- “Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial,” Ylinen et al, Journal of the American Medical Association, 2003.
- “Effects of neck muscle training in women with chronic neck pain: one-year follow-up study,” Ylinen et al, Journal of Strength & Conditioning Research, 2006.
- “Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study,” Ylinen et al, Europa Medicophysica, 2007.
- “Dose-Response Relationship of Specific Training to Reduce Chronic Neck Pain and Disability,” Nikander et al, Medicine & Science in Sports & Exercise, 2006.
- “Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials,” Bertozzi et al, Physical Therapy, 2013.
- “Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review,” Cheng et al, J Phys Ther Sci, 2015.
- “Exercises for mechanical neck disorders,” Gross et al, Cochrane Database of Systematic Reviews, 2015.
- “The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study,” Ruivo et al, Manual Therapy, 2015.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. Holden 2023 The Lancet Rheumatology.