Dissertations / Theses: 'Neck pain – Alternative treatment'

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Abrahamsson, Karin. "Rygg och nackvärk, före, under och efter reflexologisk behandling." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-9204.

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Människor med rygg- och nackvärk utgör en stor patientgrupp inom primärvården. Många blir inte hjälpta av de behandlingsmetoder som erbjuds. Samtidigt efterfrågas Komplementär och Alternativ Medicinska (KAM) behandlingar allt mer från allmänheten. Behovet att öka hälso- och sjukvårdens kunskap om KAM som behanlingsalternativ sågs. Studiens syfte var att beskriva människors erfarenheter i samband med rygg- och nackvärk och reflexologisk behandling. Metoden var kvalitativ ansats med semistrukturerade intervjuer som analyserades utifrån kvalitativ innehållsanalys. Urvalet omfattade sju klienter som sökt reflexologisk behandling pga rygg- och/eller nackvärk och identifierades genom tre olika reflexologer i Skåne län. I resultatet identifierades kategorin Vardagen med underkategorierna Smärta och värk, Försök till anpassning samt Söka vård och behandling. I Kategorin fysiska och psykiska sensationer sågs underkategorierna Personligt bemötande, Zonsmärta, Cirkulationsökning samt Avslappning. I Kategorin Förändring av vardagen ingick Symtomlindring, Hjälp till självhjälp samt Arbete och idrott. Slutsatsen dras att reflexologisk behandling kan erbjuda bra smärtlindring för människor med rygg- och nackvärk samt erbjuder en chans till avslappning, bättre sömn, vara aktiv i arbetslivet och få ny energi. Mer forksning inom reflexologisk behandling behövs.
People with back- and neck pain are common in primary care. Lot of patients don´t get the help needed. Meanwhile the public´s interest in Complementary Alternative Medicine (CAM) is growing. Need was identified to in the Healthcare system increase the knowledge about CAM´s options of treatment. The aim of this study was describing peoples experiences associated with back-and neck pain and reflexological treatment. The method was qualitative approach with semistructured interviews that analysed with contentanalysis. Sample included seven clients soughted reflexological treatment for back-and/or neck pain, wich identified through three flexologists in South Sweden. In The result the category Everyday life was identified with subcategories Pain and ache, Attempts to adapt and also Seek care and treatment. In the category Physically and mentally sensations subcategories Personal treatment, Zone pain, Increasing of circulation and also relaxation was identified. In the category Change in everyday life subcategories Symptom relief, Help to self-help and also work and sports were observed. Conclusion is that Reflexological treatment relief pain for people with back- and neck pain, it also provides chance for relaxation, better sleep, be able to work and to get new energy. More research about reflexological treatment is needed.

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Kjellman, Görel. "Neck pain : analysis of prognostic factors and treatment effects /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med662s.pdf.

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Svedmark, Åsa. "Neck pain in women : effect of tailored treatment and impact of work environment." Doctoral thesis, Umeå universitet, Fysioterapi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-139394.

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Introduction: Musculoskeletal pain is a common problem in the working population. In Sweden, 40% of women and 30% of men report suffering from neck and shoulder pain weekly. The underlying cause for neck pain is often not known and the treatment is commonly guided by the individual’s symptoms. However, there is a lack of knowledge on how to receive the best effect based on the individual’s symptoms and functional limitations, and therefore this has been scarcely evaluated in research. Furthermore, the impact of work exposure and stress on long-term treatment for persons with neck pain is not clear. Aims: To develop (paper 1) and to evaluate a decision model for tailored treatment in women with neck pain (paper 2). Moreover, to determine if risk factors at work and stress influence intermediate and long-term treatment results (paper 3). Further, to investigate if changes in self-reported pain and disabilities are associated with changes of physical test outcomes of the neck and shoulder region after treatment (paper 4). Methods: In an RCT, 120 working women with non-specific neck pain were randomized to three different groups – tailored treatment (TT), non-tailored treatment (NTT) or treatment-as-usual (TAU) for an 11 weeks intervention with short-term, intermediate-term and long-term follow-ups. The TT group was guided by a decision model with cut-off levels to indicate impairments. The NTT group received two established treatment components randomly from those not indicated, and TAU group did not receive any treatment within the study. The RCT primary outcomes were self-reported neck pain and neck disability. A linear mixed model was used for analysing the effects. One week after the end of intervention work exposure and stress were assessed at a work-place visit and associations to treatment results were tested for, and mixed models were used to estimate longitudinal associations. Associations between self-reported neck problems and physical outcomes were estimated with univariate and multiple regressions analysis. Results: No differences between TT and NTT were revealed for neck pain and disability. In comparison to TAU, the TT and NTT groups both showed improvements at short-term follow-up, but not at intermediate and long-term follow-up. High stress level and low self-estimated control at work were associated with more pain and disability at the intermediate and long-term follow-ups. After intervention and at the intermediate-term follow-up, reduced neck pain, disability and frequency of symptoms were associated with increased peak speed of head rotation and cervical range of motion. Conclusion: Tailored treatment according to the decision model was not superior to the non-tailored treatment in women with non-specific neck pain. One explanation for this can be the weak relationships found between neck pain and disability and physical test outcomes. Further, perceived stress and psychosocial work exposure were associated with self-reported neck problems and should be taken into account to optimize the effects in neck pain rehabilitation.
Bakgrund: Nack- och skulder-smärta är ett vanligt tillstånd som förekommer över hela världen. I Sverige skattar 30-40% besvär från nacke och skuldror mätt under en veckas tid. Generellt rapporterar kvinnor mer nack- och skulder-besvär än män. I avhandlingen är det ospecifik nacksmärta som har studerats, det inkluderar inte t.ex. Whiplash-skador, diskbråck eller andra mer specifika diagnoser. Den bakomliggande orsaken till ospecifik nacksmärta är, precis som beteckningen antyder, ofta inte känd och individens symptom och funktion är istället vägledande i undersökning och behandling samt utvärdering av behandling. Studier har visat att i jämförelse med friska har individer med ospecifika nackbesvär ofta sämre muskulär nackstyrka, minskad rörlighet i nacken och är något långsammare vid test av huvudrörelser. Behandlingen riktar sig ofta mot något av dessa fynd med bl.a. styrketräning av nackmuskler och/eller manuella tekniker för rörelseökning. Studier har dock visat att behandlingen endast ger måttliga resultat och att de positiva resultaten bara är kortvariga. I kliniken försöker man individanpassa behandlingen utifrån patientens behov men det finns väldigt lite forskning om detta utan studier utvärderar likadan behandling för hela grupper. Det saknas fortfarande kunskaper om hur man på bästa sätt individanpassar behandling så att den blir skräddarsydd utifrån individens symptom och funktion samt utvärderar detta. Syftet med avhandlingen var att undersöka om en intervention med skräddarsydd behandling (som också innehöll specifik aktiv träning) utifrån en beslutsmodell med fysiska tester och frågor om symtom är effektivt för att uppnå positiva effekter i självskattad smärta och funktion (artikel 1 och 2). Den skräddarsydda behandlingen jämfördes mot en grupp som fick samma upplägg men inte skräddarsydd behandling. Vidare undersöktes om båda dessa behandlingsgrupper var effektivare än en grupp som inte fick någon behandling i studien. Dessutom undersöktes om påverkan från arbetsmiljön i form av fysisk och psykosocial belastning samt upplevd stress påverkade behandlingsresultaten efter interventionen (artikel 3). Slutligen undersöktes om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade koppling till varandra dels före interventionen och dels i termer av förändringar efter interventionen (artikel 4). Metod: I en randomiserad kontrollerad interventionsstudie (RCT) inkluderades 120 kvinnor i åldrarna 20-65, alla i arbete, och som hade ospecifika nackbesvär. De lottades till tre grupper, (1) skräddarsydd behandling (Tailore treatment, TT), (2) icke-skräddarsydd behandling (Non-tailored treatment, NTT) och (3) en kontrollgrupp (Treatment-as-usual, TAU) som inte fick någon behandling i studien men var fria att söka vård på egen hand. Kvinnorna i TT-gruppen fick behandlings-komponenter utifrån testresultaten i beslutsmodellen. Det kunde läggas till någon behandlingskomponent om det visade sig behövas utifrån individens behov i vardagen. Detta undersöktes genom en strukturerad intervju-teknik som kallas Problem Elicitation Technique (PET). Kvinnorna i NTT-gruppen fick två lottade behandlings-komponenter som inte matchade deras behov utifrån testerna i beslutsmodellen. För båda behandlings-grupperna var interventionen 11 veckor med inbokade behandlingstillfällen 2-3 gånger per vecka, samtliga tillfällen vägledda av fysioterapeut. Data för alla tre grupper samlades in innan interventionen samt 3, 9 och 15 månader efter start av interventionen. Gruppskillnaderna analyserades med en ”linear mixed model”. En vecka efter intervention gjordes ett arbetsplatsbesök hos individerna i alla tre grupper. En erfaren ergonom observerade individernas fysiska arbetsbelastning med ett ergonomiskt bedömningsinstrument, Quick Exposure Check (QEC), och individerna skattade också den psykosociala arbetsmiljön i ett frågeformulär, QPS Nordic, samt upplevd stress. För att undersöka om den fysiska och psykosociala arbetsbelastningen samt stress påverkade resultaten från interventionen analyserades data med linjär regression och mixed model. För att undersöka om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade något samband användes linjär regressionsanalys. Resultat: Att skräddarsy behandlingen utifrån den testade beslutsmodellen var inte effektivare än att inte skräddarsy. I jämförelse med kontrollgruppen självskattade båda behandlingsgrupperna mindre smärta, bättre funktion och mindre symptom efter interventionen. I de länge uppföljningarna (9 och 15 månader) var dock skillnaderna mellan grupperna inte längre signifikanta förutom att båda behandlingsgrupperna, till skillnad från kontrollgruppen, upplevde sig bättre än innan behandling. Det visade sig att upplevd hög stressnivå och låg kontroll på arbetet hade samband med mer självskattad nacksmärta, sämre funktion och lägre arbetsproduktivitet. De fysiska testerna och självskattade nackbesvär hade bara svaga samband. På baslinjenivå, innan interventionen, fanns det samband mellan hög nackstyrka och låg självskattad funktion och låg frekvens på symptomen, samt mellan att vara långsam i testet av snabba huvudrörelser och hög smärta. Efter interventionen hade individernas förändring i självskattad smärta fortfarande bara samband med snabba huvudrörelser. Förbättring i självskattad funktion och symptom hade samband till ökad hastighet i snabba huvudrörelser och ökat rörelseutslag nackrotation. Sammanfattning: För kvinnor i arbete med ospecifika nackbesvär var det inte mer effektivt att skräddarsy behandling/träning utifrån en beslutsmodell jämfört med att slumpmässigt välja ut behandlingskomponenter från samma behandlingsarsenal. En förklaring kan vara att det fanns endast låga samband mellan självskattad smärta och funktion och de fysiska testerna. Upplevd stress och kontroll i arbetet visade sig ha samband med självskattad smärta, funktion och arbetsproduktivitet och bör tas i beaktande i framtida interventioner för individer med nacksmärta.

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McLean, Sionnadh M. "Conservative management of non-specific neck pain : effectiveness of treatment, predictors of treatment outcome and upper limb disability." Thesis, University of Hull, 2007. http://hydra.hull.ac.uk/resources/hull:5857.

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Neck pain is a prevalent musculoskeletal problem that consumes considerable NHS resources. The socioeconomic impact for individuals, industry and society is high. However research into the management of neck pain is sparse. Reviews of the evidence revealed relatively little high quality evidence relating to the development, progression and management of non-specific neck pain. There is emerging evidence for the use of dynamic strengthening, proprioceptive and postural exercises for neck pain, although it is not known whether group exercise based on this emerging evidence is effective compared to usual physiotherapy. There is little evidence for prognostic factors for the progression of neck pain or outcome of treatment. Consequently clinicians are unable to predict which patients are likely to develop recurrent, persistent or chronic problems and have difficulty directing patients towards the most effective treatment approaches. Finally, there is anecdotal understanding that neck problems may lead to the development of upper limb disability and that upper limb disability may influence treatment outcome for patients with neck pain. Currently the relationship between neck pain and upper limb disability remains unquantified. The information gained from these reviews was utilised in the design of a randomised controlled trial to compare group based Graded Exercise Treatment and Usual Physiotherapy (GET UP) for patients with non-specific neck pain. The first aim of this thesis was to investigate the effectiveness of a graded neck and upper limb exercise programme (GET) compared with "usual physiotherapy" (UP). A randomised controlled trial of 151 patients showed that patients receiving UP and GET interventions had reduced neck pain and disability six months following intervention. Neck pain and disability scores in the UP group reduced by 7.7% at six month followup whilst those in the GET group reduced by 5.0%. For patients who completed treatment as per protocol, GET (8.8%) was as effective as UP (9.0%). The second aim was to investigate patient psychological, socio-demographic and physical variables which predicted treatment outcome. After adjusting for baseline neck pain and disability and treatment allocation, general linear modelling identified that, regardless of intervention, deprivation status significantly predicted treatment outcome at six months. In addition, baseline fear avoidance and treatment allocation interacted to predict six month outcome. Patients with high fear avoidance were predicted to have better outcome following GET. Those with low fear avoidance were predicted to have better outcome in UP. The final aim was to investigate the relationship between neck pain and upper limb disability. Pair wise analysis revealed a strong positive correlation between neck pain and disability and upper limb disability. Linear regression indicated that the severity of upper limb disability was predicted by two main baseline variables: higher NPQ scores and lower pain self efficacy scores. In conclusion GET and UP produced small but clinically meaningful reductions in neck pain and disability. Adherence to both forms of treatment, particularly GET, was a problem. For the subgroup group of patients who adhered to the treatment protocol, GET was as effective as UP, therefore the barriers to adhering with these treaments need to be better understood by clinicians and researchers alike. The GET programme appeared to be particularly beneficial for patients exhibiting high levels of fear avoidance beliefs. Therefore patients with neck pain should be assessed for the presence of fear avoidance beliefs and where appropriate directed towards active neck and upper limb rehabilitation. Patients from areas of social deprivation fared less well with physiotherapy than those from more affluent areas, regardless of intervention type. There is a need for more research into the influence of deprivation on treatment outcome. In particular there is a need to develop and evaluate innovative and targeted approaches which are suitable for such patients. Finally, clinicians should be aware that higher levels of neck pain and lower levels of pain self efficacy may provide an early indication of the presence of upper limb disability. Effective ways of managing neck related upper limb disability need further investigation since neither treatment was effective at reducing upper limb disability.

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Leung, Chun Chuen. "Study of long-term efficacy of electroacupuncture for chronic neck pain : a randomized controlled trial." HKBU Institutional Repository, 2012. https://repository.hkbu.edu.hk/etd_ra/1440.

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Huis, in 't Veld Maria Hendrika Aleida. "Work-related neck-shoulder pain the role of cognitive-behavioural factors and remotely supervised treatment /." Enschede : University of Twente [Host], 2007. http://doc.utwente.nl/58101.

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Hurst, Hugh C. "Outcomes of back and neck pain patients undergoing chiropractic treatment and can these be predicted?" Thesis, University of Portsmouth, 2011. https://researchportal.port.ac.uk/portal/en/theses/outcomes-of-back-and-neck-pain-patients-undergoing-chiropractic-treatment-and-can-these-be-predicted(cc9d6a84-62dd-4a82-8679-5c5458e65182).html.

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Background Back and neck pain are the primary musculoskeletal complaints responsible for absenteeism from work as well as high healthcare costs. A large proportion of back and neck pain sufferers still experience pain at 12 months and most patients experience relapses. Although musculoskeletal complaints are the second most common reason people take sick leave in the UK, guidelines produced by various bodies both in the UK and abroad for managing back and neck pain have failed to significantly reduce work disability. Self-report subjective outcome measures are being used increasingly in healthcare to assess the quality of care received by patients. However, despite years of research, there is no consensus in the literature as to how one categorises improved patients from those who have not improved using these outcome measures. Moreover, although researchers have investigated predictors of outcome for back and neck pain patients undergoing manual therapy, these is a lack of consensus about whether or not it is possible to predict outcomes in patients, and if it is, which factors consistently do so. Methods Consecutive new patients with back and neck pain presenting at a private chiropractic practice in Bristol completed a questionnaire consisting of a pain diagram and a self-report outcome measure, namely the Bournemouth Questionnaire (BQ). This questionnaire consists of seven questions which assess the commonly-measured domains of the biopsychosocial model of musculoskeletal conditions. This questionnaire is preceded by demographic information on the patient and clinical questions about the patient’s complaint. For the purposes of reassessment on the 4th/5th treatment and the 10th treatment, a post-treatment BQ, which includes a Patient Global Improvement Scale (PGIS), was completed by the patients. Three methods were used to determine ‘improvement’ in patients, (i) the direct method, using the PGIS, (ii) the anchorbased method, comparing total BQ change scores with the response on the PGIS as the anchor, and (iii) the distribution-based method, using 0.5 of the standard deviation of the group change score as the cut-off for ‘improvement’. All potential predictor variables that were significantly associated with self-reported ‘improvement’ were entered into multivariable regression analysis to determine final predictive models consisting of predictors independently associated with the outcome. The sensitivity and specificity of the model was calculated to determine the ability of the model to discriminate between improved and non-improved patients. To calculate the diagnostic accuracy of the model, the area under the Receiver Operator Characteristic Curve (AUC) was calculated. Results The clinical and demographic characteristics were similar to other back and neck research populations. There was moderate to good agreement between the three methods of defining improvement in these cohorts with best agreement between the anchor and distribution-based methods. As a result the anchor-based method was used to identify patients who had improved. In the back pain cohort, the final predictive models had good sensitivity (86.1% at treatment 4/5 and 92.4% at treatment 10) for correctly identifying improvement but less specificity (48.5% at treatment 4/5 and 48.9% at treatment 10) for correctly identifying nonimprovers. The discriminative ability of the models (AUC) was 0.75 at treatment 4/5 and 0.83 at treatment 10. In both models a short history of pain, a smaller area shaded on the pain diagram and a total BQ score of over 30/70 were identified as predictors of outcome. At treatment 4/5 patients who had good treatment expectation and rated their general health as good were also associated with improvement. At treatment 10 inappropriate markings on the pain diagram and regular alcohol consumption were also associated with improvement. In common with back pain, the predictive model in the neck pain cohort included a total baseline BQ score over 30/70 as associated with the outcome. At treatment 4/5, in common with the back pain, patients improved if they had a short pain history, good general health perception and shaded a smaller area on the pain diagram. At treatment 10 neck pain patients who smoked were associated with improvement. The final predictive model for neck pain patients had good sensitivity (77.8%) and moderate specificity (66.5%) at treatment 4/5, and the same sensitivity and specificity (67%) at treatment 10. The discriminative ability of the models (AUC) at treatment 4/5 and 10 was 0.76 and 0.71 respectively. Conclusion Being able to distinguish between and identify patients at an early stage with good and poor prognosis gives the clinician the opportunity to direct treatment approaches and manage patients more effectively. This study has shown that it is possible to identify characteristics of patients and their condition at baseline that can predict outcome at a later stage in their treatment. As might be expected, patients with more acute conditions, less severe pain and disability and less area in pain are more likely to improve. It is believed that this is the first time the area shaded on the pain diagram has been identified as a predictor of outcome.

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Altmann, Janet Rosemary. "Neck and shoulder pain in nurses working in seven wards of Tygerberg hospital : quantifying the problem and exploring the risks." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6893.

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Thesis (MSc)--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: Background: There is a high prevalence of musculoskeletal problems, including neck and shoulder pain (NSP) among nurses worldwide. Tygerberg hospital (TBH) is the second largest hospital in South Africa with a large complement of nurses. The prevalence of NSP and risks associated therewith have not previously been determined at TBH. It is unknown how the nurses at TBH experience NSP in their workplace. Objective: This study questioned whether the 12 month prevalence of neck pain, shoulder pain and combined NSP is similar to worldwide reports, and questioned the degree of association of NSP with lower back pain and demographic risk factors in the nursing population at TBH. Thereafter the qualitative experiences of nurses with NSP at TBH were elucidated. Methodology: A self-designed Neck and Shoulder Pain Questionnaire for nurses (NSPn) was distributed among seven wards of TBH from March to May 2009. The NSPn was compiled using the pain definition from the Nordic Musculoskeletal Questionnaire and elements of the Dutch Musculoskeletal Questionnaire. The NSPn gathered information regarding the presence of neck and shoulder pain as well as demographic and workplace risk factors. Thereafter semi-structured interviews were conducted with eight nurses working at TBH. Results: The 12 month prevalence of neck pain, shoulder pain and combined NSP was 29%, 34% and 43% respectively among a sample of 143 nurses. A high correlation of neck pain with lower back pain and of neck pain with shoulder pain was observed. No significant associations were found between age, ward module, tenure of work, and the nurses' perception of their general health and fitness with the presence of NSP. The qualitative results describe the conflict between the nurses' beliefs and their symptoms. The nurses named work-related stress as the most prevalent cause or aggravator of NSP. The main underlying cause of their stress was a shortage of nursing staff. Discussion and Conclusions: The prevalence of neck pain (29%) and shoulder pain (34%) among the surveyed TBH nurses was lower than the worldwide prevalence summary statistic of 50% and 52% respectively. However, the NSP prevalence (43%) was within the range of three international studies, suggesting that NSP is a significant concern for TBH nurses. The nurses' desire to hide pain and continue working perpetuates the problem of NSP. The underlying causes of NSP are multifactorial, with physical factors interacting with psychosocial factors. Preventative drives need to consider staffing levels and nurses' methods of coping with stress along with improvements in manual handling practices.
AFRIKAANSE OPSOMMING: Agtergrond: Daar is 'n hoё voorkoms van muskulosketale probleme, insluitend nek en skouer pyn (NSP), by verpleegkundiges wêreldwyd. Tygerberg Hospitaal (TBH) is die tweede grootste hospitaal in Suid-Afrika met 'n groot aantal verpleegkundiges. Die voorkoms van NSP en risiko's verbonde daaraan, is nog nie voorheen by TBH vasgestel nie. Dit is nie bekend hoe die verpleegkundiges by TBH NSP in hulle werksomgewing ervaar nie. Objektief: Hierdie studie ondersoek of die 12 maand teenwoordigheid van nekpyn, skouerpyn en gekombineerde NSP ooreenstem met wêreldwye aanmelding, en ondersoek die assosiasie van NSP met lae rugpyn en demografiese risiko faktore in die verpleegkunde populasie by TBH. Daarna is die kwalitatiewe ondervindings van die verpleegkundiges met NSP by TBH toegelig. Metodologie: Die self-ontwerpde "Nek en Skouer pyn in verpleegsters‟(NSPn) vraelys, is onder sewe sale vanaf Maart tot Mei 2009 versprei. Die NSPn het die die Nordiese muskuloskeletale pyn definisie en elemente vanaf die "Hollandse Bewegingsapparaat Vraelys‟ ingesluit. The NSPn het inligting oor die voorkoms van nek en skouer pyn, sowel as demografiese en werkplek faktore ingesamel. Daarna is semi-gestruktureerde onderhoude gevoer met agt verpleegkundiges wat by TBH werksaam is. Resultate: Die 12 maand voorkoms van nekpyn, skouerpyn en gekombineerde NSP was 29%, 34% en 43% onderskeidelik in die steekproef van 143 verpleegkundiges. 'n Beduidende korrelasie van nekpyn met lae rugpyn en nekpyn met skouerpyn is waargeneem. Geen betekenisvolle ooreenkomste is gevind tussen ouderdom, saal module, termyn van werk en die verpleegkundiges se persepsie van hulle algemene gesondheid en fiksheid, met die teenwoordigheid van NSP nie. Die kwalitatiewe resultate beskryf die konflik tussen die verpleegkundiges se oortuigings en hulle simptome. Die verpleegkundiges noem stres as die mees algemene oorsaak of verergeraar van NSP. Die grootste onderliggende oorsaak van stres was die tekort aan verpleegpersoneel by TBH. Bespreking en Gevolgtrekkings: Die voorkoms van nekpyn (29%) en skouerpyn (34%) was laer as die wereldwye voorkoms opsommings statistiek van 50% en 52% onderskeidelik. Maar die voorkoms van NSP(43%) was binne die grense van drie internasionale studies wat dui daarop dat NSP 'n merkbare kommer vir TBH verpleegkundiges is. Die verpleegkundiges se behoefte om die pyn weg te steek en aan te hou werk, vererger die problem van NSP. Die onderliggende oorsake van NSP is veelvoudig, met fisiese faktore en psigologiese faktore wisselwerkend op mekaar. Voorkomende veldtogte moet verpleegkundiges se stres en personeeltekorte saam met verbetering in manuele hanteringstegnieke in ag neem.

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Wong, Shing Chau. "Treatment of neuropathic pain : by Chinese scorpion (Buthus martensii Karsch)." HKBU Institutional Repository, 2011. https://repository.hkbu.edu.hk/etd_ra/1439.

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余維安. ""寒主痛" 的中醫藥文獻研究." HKBU Institutional Repository, 2009. http://repository.hkbu.edu.hk/etd_ra/1034.

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Breed, Nicolene. "Mechanical traction versus joint mobilisation in the treatment of acute non-specific neck pain in adult patients." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/79189.

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Background Non-specific neck pain (NS-NP) is a common phenomenon resulting in physical and social dysfunction, high utilisation of healthcare and economic burden. In South Africa the incidence of one or more episodes of neck pain in working people between the ages of 25 and 29 years of age is reported to range between 25% and 30% while approximations of the incidence of neck pain for people aged 45 years and above rise to 50%. The hypothesised point prevalence of acute NS-NP in the adult population is 10%. Mechanical traction and joint mobilisation are treatment modalities used for acute NS-NP. The value of mechanical traction for neck pain has been questioned because studies pertaining to the effectiveness thereof are limited, with small sample sizes and are of poor quality. Aim: To assess whether mechanical traction or joint mobilisation of the cervical spine was more effective in the treatment of acute NS-NP in adult patients, when combined with secondary treatment categories [electrotherapy (E.T.), exercise and soft tissue joint mobilisation (STM)]. Methodology: A descriptive retrospective analysis was conducted on the clinical records of patients suffering from acute non-specific neck pain who were treated at the Physiotherapy Outpatient Department of the Steve Biko Hospital from 2000-2011 . Non-probability purposive sampling was done. The inclusion criteria were as follows: age 18-50 years, acute NS-NP with or without referred pain, pain rated on the Visual Analogue Scale at first treatment and discharge, treated with joint mobilisation or mechanical traction and more than one treatment in a two week period. The exclusion criteria were as follows: cervical pathology, fractures, malignancy, surgery, whiplash-associated disorders and involvement in litigation or compensation claims. A total of 109 records were included. The outcomes of this study was calculated by the change in reported pain intensity as measured with a Visual Analogue Scale (VAS) Nicolene Breed 23032473 Page 5 in the patient records and by assessing clinical improvement. Regression analysis was employed for data analysis. Results: The treatment groups differed marginally (p=0.08) with respect to a positive change in VAS with joint mobilisation indicating a greater change in VAS scores with a mean change in VAS of 3.94mm, while the secondary treatment categories differed significantly (p=0.03) with respect to a positive change in VAS with exercise and STM with a mean change in VAS of 4.20mm seeming more effective in reducing acute NS-NP. Traction had an increased risk of poor clinical outcome in terms of pain reduction (OR:-3.26; 95% CI; 1.16-9.15). Compared to the joint mobilisation group, the traction group’s risk for poor clinical outcome was increased by 3.26. Relative to E.T., exercise and STM prevented a poor clinical outcome (OR=0.39; 95% CI; p=0.04). Conclusion: Joint mobilisation combined with exercise and STM had a clinically significant, positive outcome in the treatment of acute non-specific neck pain, as opposed to mechanical traction combined with exercise and STM.
Dissertation (MSc)--University of Pretoria, 2013.
Physiotherapy
MSc
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Hallman, David. "Autonomic nervous system regulation in chronic neck-shoulder pain : Relations to physical activity and perceived stress." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-187613.

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Neck-shoulder pain (NSP) is a highly prevalent musculoskeletal disorder with unclear causes, and effective prevention and treatment require a further understanding of the underlying mechanisms. Aberrant autonomic nervous system (ANS) regulation is a hypothesized causal element in the development and maintenance of chronic muscle pain. The overall aim of this thesis was to investigate possible differences in ANS regulation between chronic NSP and healthy control (CON) groups using both laboratory assessment and ambulatory monitoring in daily life. Four papers are included in this thesis, based on data from three groups with chronic NSP. Autonomic responses to laboratory stressors were assessed using heart rate variability (HRV), blood pressure, trapezius muscle activity and blood flow measurements (Study І) in NSP and CON. Long-term ambulatory monitoring of HRV, physical activity and perceived symptoms were assessed in Studies ІІ and IV to investigate group differences in real-life conditions. Finally, the effects of a ten-week intervention (using individually adjusted HRV biofeedback) to reinstating ANS balance in subjects with chronic NSP were evaluated using self-reported symptoms and health ratings, as well as autonomic regulation testing (i.e., evaluating HRV at rest and in response to stress) (Study ІІІ). The main findings from the four studies demonstrated aberrant ANS regulation in the NSP group compared to CON, which was predominantly characterized by diminished parasympathetic cardiac activity during rest and sleep, and altered sympathetic reactivity to laboratory stressors (Studies І, ІІ and IV). Different patterns in physical activity were observed between the NSP and CON groups, with reduced physical activity during leisure time in the NSP group (Studies ІІ and IV). Physical activity was found to be positively associated with HRV. Positive effects of HRV-biofeedback were found on perceived health, including social function, vitality and bodily pain, and improved HRV (Study ІІІ). In conclusion, imbalanced ANS regulation was demonstrated among persons with chronic NSP at both the systemic and local levels. Diminished parasympathetic activity in NSP was modulated by lower levels of physical activity in leisure time. Interventions targeting ANS functions might benefit persons with chronic NSP.

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White, Peter John. "A study for the efficacy of a 'western' acupuncture protocol for the treatment of chronic mechanical neck pain." Thesis, University of Southampton, 2002. https://eprints.soton.ac.uk/18100/.

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Ngor, Aaron Seav. "The Influence of Dry Cupping Therapy on Musicians with Chronic Neck Pain: An Initial Case Series." Ohio University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1525726057063134.

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李思聞. "肩痛的激痛點針刺取穴方案初探." HKBU Institutional Repository, 2017. https://repository.hkbu.edu.hk/etd_oa/449.

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研究背景：肩痛是临床的常见症状，常因不正确姿势、受凉、外伤、运动劳损等引发，多被诊断为局关节周围炎、属部的肌臆炎等’带来的疼痛和肢体活动障碍都严重影响正常生活。针灸治疗盾痛效果显著’传统中医在眉痛的诊疗中已有详尽论边，而近年西方医学提出的激痛点疗法，在治疗痛症上也有明确的疗效。总结局痛的激痛点针刺取穴方案，探讨其与传统针灸的失系’对发展当代针灸有十分重要的理论意义和临床价值。研究目的：初步总结盾痛的激痛点针刺取穴方案，探讨激痛点和传统针灸的相关性, 为临床提供新思路。研究方法：文献研究。结论：眉痛的激痛点针刺取穴方案为：盾前痛取胸大肌锁骨部、胸小肌、肱二头肌、喙肱肌、背阔肌、冈下肌、前三角肌、前斜角肌、中斜角肌激痛点；属后痛取大圆肌、小圆肌、肩胛下肌、肱三头肌长头第一、下斜方肌第三、后三角肌激痛点；肩外侧疼痛取中三角肌、冈上肌激痛点。此法优势在于理论系统与诊疗过程明确、操作规范、疗效显著，是属痛的治疗的新思路。对比发现，激痛点理论与经筋理论相似。激痛点针刺取穴与中医整体辨证论治的结合, 势必有助提高临床疗效，值得深入探索。關键字：肩痛激痛点针刺取穴文献研究

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Quinn, Fionnuala. "Complementary and alternative medicine in the treatment of low back pain, with a focus on reflexology." Thesis, University of Ulster, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429001.

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Yeung, Wai-chow David, and 楊煒秋. "A pilot study of holistic energy healing for frozen shoulder." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45169548.

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Aranha, Maria Fernanda Montans 1981. "Evaluation of acupuncture, electroacupuncture and sham acupuncture on the treatment of myofascial pain at the upper trapezius muscle." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288256.

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Orientador: Maria Beatriz Duarte Gavião
Texto em português e inglês
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
Made available in DSpace on 2018-08-24T18:01:40Z (GMT). No. of bitstreams: 1 Aranha_MariaFernandaMontans_D.pdf: 1980605 bytes, checksum: 9f4ae0a15227cd5ca93e4bb7d7713aaf (MD5) Previous issue date: 2014
Resumo: A dor miofascial (DM), proveniente de um ponto gatilho miofascial (Pg), é a principal causa de dor de cabeça e pescoço. A sua presença é associada à rigidez muscular e estresse e pode influenciar a qualidade de vida de pacientes sintomáticos. Imagens ultrassonográficas do tecido disfuncional têm sido realizadas com o intuito de avaliar objetivamente o Pg. Com o objetivo de avaliar o efeito da acupuntura e da eletroacupuntura no tratamento da DM da parte superior do músculo trapézio, sessenta voluntárias com idade entre 18 e 40 anos, índice de massa corpórea entre 18 e 30 Kg/m2, com pelo menos um ponto gatilho na parte superior do músculo trapézio, dor local ou referida por mais de seis meses foram randomizadas em três grupos: eletroacupuntura (EA), acupuntura (AC) e acupuntura SHAM (SHAM). O avaliador e as voluntárias eram cegos aos tratamentos. Os pontos de acupuntura utilizados foram: VB20, VB21, F3 e IG4, além de no máximo, 2 pontos ashi em cada lado do trapézio superior. A efetividade do tratamento, assim como a manutenção dos resultados até um mês após o final do tratamento, foram avaliada pela intensidade de dor (escala visual analógica: EVA), amplitude de movimento cervical (fleximetria), qualidade de vida (SF-36), estresse (área abaixo da curva: AUCG; resposta do cortisol ao acordar: CAR), imagem de ultrassom (área do Pg). De acordo com sua distribuição os dados foram analisados pelos testes: teste-t pareado, Wilcoxon signed rank, ANOVA para medidas repetidas ou teste de Friedman, ANOVA ou Kruskal Wallis. Foi aplicado o teste de correlação de Pearson. O nível de significância foi de ?= 0,05. Foi observada redução na dor geral (DG) nos grupos EAC (P<0.001) e AC (P<0.001) após todas as sessões. Na reavaliação, a dor no trapézio direito (TPzD) diminuiu para os grupos EA (P<0.001) e AC (P=0.025), já no trapézio esquerdo (TPzE), apenas o grupo EA mostrou melhora (P<0.001). Em relação à DG correu interação dos fatores "fase de avaliação" e "grupo" para AC e EAC, e para dor no TPzD e E apenas para o grupo EA. Após o tratamento houve aumento da rotação para a esquerda no grupo EA (P=0.049), e aumento da inclinação e rotação para a direita no grupo AC (P=0.005; P=0.032). Houve aumento da AUCG (P=0.006) e CAR (P<0.001) no grupo AC. Em relação aos dados obtidos pelo SF-36, o grupo SHAM apresentou aumento significativo da dor (P=0.005); os grupos EA e AC mostraram aumento nos mesmos domínios, com valores respectivos de P: capacidade funcional (P=0.011; P=0.016), aspectos físicos (P=0.027; P=0.13), dor (P=0.010; P=0.003), estado geral da saúde (P=0.017; P=0.011), vitalidade (P=0.010; P=0.011), saúde mental (P=0.018; P=0.014) e componente físicos (P=0.019; 0.002). Ocorreu diminuição na área do ponto gatilho (US) nos grupos EA (TPzD: P<0.001; TPzE: P=0.001) e AC (TPzD e TPzE P<0.001), e no grupo SHAM apenas no TPzE (P=0.036). A EA se mostrou mais eficaz no alívio da dor quando comparada aos outros grupos. Tanto AC quanto EA foram eficazes na melhora da morfologia do tecido muscular (US) e da qualidade de vida. A AC parece ser mais indicada na diminuição do estresse e na melhora da amplitude de movimento cervical em mulheres com dor miofascial no trapézio superior
Abstract: Myofascial pain (MP), caused by myofascial trigger points (MTrP), is of the main cause of headache and neck pain. It is associated with muscular stiffness, stress and can influence the quality of life of symptomatic patients. Ultrasound images of dysfunctional tissue have been used aiming to objectively evaluate the myofascia trigger point. Aiming to evaluate the effect of acupuncture and electroacupuncture on the treatment of MP at the upper trapezius muscle, sixty women aged between 18 and 40 years old, body max index between 19 and 30 Kg/m2, presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized in to and three groups: electroacupuncture (EAC), acupuncture (AC) and SHAM-acupuncture (SHAM). Both examiner (CEEM) and volunteers were blinded to the treatments. The selected acupoints were VB20, VB21, F3 and IG4, besides a maximum of 2 "ashi points" in each upper trapezius. The effectiveness of treatment (eight sessions), as well as it maintenance till one month follow up, were evaluated concerning the intensity of pain (Visual analog scale: VAS), range of motion (fleximetry), quality of life (SF-36), stress (area under the curve to the ground: AUCG; cortisol awaking response: CAR) and ultrasound image (area of MTrP). Influencing factors and the menstrual cycle phases were monitored. According to its distribution, data were analyzed by pared t-test, Wilcoxon signed rank, ANOVA repeated measures, Friedman test, ANOVA or Kruskal Wallis. Pearson¿s correlation was applied. The level of significance was set in ?= 0.05. It was observed reduction on general pain (GP) on treated groups after all sessions (EA: P<0.001; AC: P<0.001). After treatment, intensity of pain on the right trapezius (RTPz) decreased in the EA (P<0.001) and AC (P=0.025) groups, but on the left trapezius (LTPz) it was only observed in the EA group (P<0.001). There was interaction of factor "time of evaluation" with factor "group" for GP in the AC and EA groups; and for pain at the RTPz and LTPz only in the EA group. There was increase on rotation to the left in the EA group (P=0.049) and on inclination and rotation to the right on group AC (P=0.005; P=0.032). There was increase on AUCG (P=0.006) and CAR (P<0.001) in the AC group. While SHAM presented significant increase only on bodily pain (P=0.005), EA and AC showed increase at the same following domains, with respectively P values: physical function (P=0.011; P=0.016), role physical (P=0.027; P=0.13), bodily pain (P=0.010; P=0.003), general health (P=0.017; P=0.011), vitality (P=0.010; P=0.011), mental health (P=0.018; P=0.014) and physical components (P=0.019; 0.002). It was observed a decrease on MTrP area (US) in the groups EA (TPzD: P<0.001; TPzE: P=0.001) and AC (RTPz e LTPz P<0.001), and in the SHAM groups only at the LTPz (P=0.036). The EA group has shown to be more effective on pain relief when compared to other groups. Both AC and EA were effectiveness improving tissue morphology (US) and quality of life. AC seems to be more indicated to the decrease stress and increase cervical range of motion than EA in women with myofascial pain at the upper trapezius
Doutorado
Anatomia
Doutora em Biologia Buco-Dental

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Marhold, Charlotta. "Musculoskeletal Pain and Return to Work : A Cognitive-Behavioral Perspective." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5234-5/.

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King, Nicholas. "Effects of physical therapy for patients with cervical radiculopathy : A literature review." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-28549.

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Background: Neck pain is a major public health with great effects on both the individual and society. Cervical radiculopathy is a relatively common form of neck pain with neurological symptoms. Physical therapy is often the first treatment but there is paucity in literature reviews investigating the effects of physical therapy. Objective: To assess the effects of physical therapy for cervical radiculopathy. Methods: A literature search was conducted in PubMed, CINAHL, PEDro and Web of Science. A total of 12 RCT articles were included in the study. The articles were reviewed based on the aims of the study and the PEDro scale. Results: Eight studies of moderate quality and four high quality. Most studies used the same outcome measures. Most common interventions were traction and manual therapy. Outcomes were varied with some reporting positive effects and others no change. Treatment periods, number of sessions and follow-up varied. In most cases, the positive results wore off at follow-up and differences between groups less pronounced. Conclusions: The quality of RCTs investigating cervical radiculopathy is variable. There is limited evidence suggesting that physical therapy treatment can have a measurable and significant long-term effect on cervical radiculopathy.
Bakgrund: Nacksmärta är ett allvarligt folkhälsoproblem med stor effekt på både den enskilde och samhället. Cervikal radikulopati är en relativt vanlig form av nacksmärta med neurologiska symtom. Fysioterapi är ofta den första behandlingen för detta tillstånd men det är brist på litteraturstudier som undersöker fysioterapins effekter. Syfte: Att undersöka effekterna av fysioterapi för cervikal radikulopati. Metod: Litteratursökningar gjordes i PubMed, CINAHL, PEDro och Web of Science. Totalt inkluderades 12 RCT artiklar i studien. Artiklarna granskades utifrån studiens frågeställningar samt PEDro kvalitetsgranskningsmall. Resultat: Åtta studier var av måttlig kvalitet och fyra hög kvalitet. De flesta studier använde samma utfallsmått och alla uppmätte smärta, funktionshinder och funktion. De två vanligaste behandlingarna var traktion och manuell terapi. Resultaten av insatserna varierade då vissa rapporterade positiva effekter och andra ingen förändring. Behandlingsperioder, antal sessioner samt uppföljning varierade. I de flesta fall, så avtog de positiva resultaten vid uppföljning och skillnaden mellan grupperna blev mindre uppenbara. Konklusion: Denna litteraturöversikt påvisade att kvaliteten på de RCT studier som undersöker cervikal radikulopati varierar. Resultaten visar att det finns begränsad evidens som tyder på att fysioterapi kan ha en mätbar och betydande inverkan på cervikal radikulopati i längden.

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Carling, Carl. "Sjukgymnastikbehandling av patienter med nacksmärta efter klassificering i subgrupper enligt Treatment Based Classification, TBC. : Tre kvasi-experimentella fallstudier med AB-design och 1-månadsuppföljning." Thesis, Uppsala universitet, Fysioterapi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-314855.

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Objective: In three kvasi-experimental single-case studies regarding patients with neck-pain who after sub-grouping using Treatment Based Classification (TBC), were placed in the subgroups centralization or mobilization, describe how and why they were placed in that particular subgroup and then to evaluate the effects on function and pain of the specific treatment proposed for that subgroup. Method: The process of sub-grouping is described. Function and pain were measured with the Neck Disability Index (NDI) and Numeric Pain Rating Scale 0-10 (NPRS) before, during and after the treatment-period and 1 month after the treatment-period had ended. Results: The use of TBC showed positive results with increased levels of function and decreased patient-reported neck pain in all three single-cases. Conclusion: The TBC-system may be used for improving function and pain in patients with neck pain. More studies of the validity and reliability and randomized studies of the TBC-system are needed before it could be recommended generally for physiotherapists.

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Abdulrahman, Mjilan, and Emelie Johansson. "Patienters upplevelser och positiva effekter av komplementär och alternativmedicin vid smärta : En litteraturöversikt." Thesis, Högskolan Dalarna, Omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:du-30342.

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Bakgrund: Arton procent av Sveriges befolkning lider av långvarig smärta, men hur stort mörkertalet är vet man inte. Av den äldre befolkningen har 54% kvinnor och 38% män långvarig smärta. Smärtan påverkar flera faktorer, allt från sämre välmående och fysisk trötthet, till påverkan på socialt liv och arbete. Kostnaderna för samhället beräknas varje år kosta 87.5 miljarder kronor i direkta och indirekta kostnader. Komplementär- och alternativmedicin är ett samlingsnamn för behandlingar som inte ingår i den traditionella medicinska behandlingen, bland annat massage, akupunktur, transkutan elektrisk nervstimulering (TENS), kognitiv beteendeterapi (KBT) och meditation/yoga. Syfte: Att beskriva patienters upplevelser och positiva effekter av alternativ- och komplementärmedicin vid långvarig smärta. Metod: Studien genomfördes i form av en litteraturöversikt och baserades på 14 vetenskapliga artiklar med kvalitativ eller kvantitativ ansats. Sökningarna gjordes i databaserna CINAHL och PubMed. Resultat: Tre huvudteman framkom i resultatet vilket var ökat välbefinnande, smärtlindring och ökad rörelseförmåga. Studierna visade att patienterna upplevde god smärtlindring och ökad livskvalité både fysiskt och psykiskt vid behandling med komplementär- och alternativmedicin. Patienter som inte uppnått smärtlindring genom den traditionella vården upplever god smärtlindring med hjälp komplementär- och alternativmedicin. Slutsats: Komplementär- och alternativmedicin kan vara ett alternativ till traditionell behandling och ibland även ett första alternativ av flera anledningar, bland annat för att undvika biverkningar från läkemedel.
Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion: Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

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Reynolds-Wilcox, Wendy Lee. "The impact of child life non-pharmacologic pain interventions on pediatric patient's pain perception in the emergency department." CSUSB ScholarWorks, 2004. https://scholarworks.lib.csusb.edu/etd-project/2645.

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The purpose of this current study is to examine the impact of non-pharmacologic pain interventions administered by trained Child Life professionals in an emergency department on pain perception in children. Results showed no significant decrease in children's pain report during the medical procedure compared to before the medical procedure. However, pain after the medical procedure is significantly less than pain during the medical procedure.

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Stenberg, Gunilla. "Genusperspektiv på rehabilitering för patienter med rygg- och nackbesvär i primärvård." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-52274.

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Introduction Gender as a social and cultural construction has an impact on physiotherapist and patient beliefs, understanding, and behaviour and could affect physiotherapy encounters. Gender studies in early rehabilitation are scarce. The aim of this thesis was to study gender during different parts of the rehabilitation process for primary health care patients with neck and back pain. Method The analyses are based on data from three different samples. One sample is composed of physiotherapists and two samples consist of patients consulting primary health care providers because of neck and back pain. All data were gathered from primary health care provided in Västerbotten County. Baseline data on 73 physiotherapists and 586 of their patients with neck and back pain were collected by questionnaire during three consecutive days in 2006. Patient data included affected pain site and treatment procedures used by the physiotherapist (Study I). Differences in treatment procedures used by female and male physiotherapists and differences in use for female or male patients were analysed using Chi square-test, Fisher’s exact tests, Mann-Whitney U tests and logistic regressions with cluster analysis. Thematised interviews with 12 patients were made before the patient’s first appointment with a physiotherapist or doctor and repeated after three months. Data were analysed according to grounded theory (Study II) and qualitative content analysis (Study III). A comprehensive questionnaire was answered at the first appointment when patients sought a physiotherapist in primary health care. The questionnaires included questions about pain intensity, self-rated health, function, psychological stress reactions, domestic work, work environment, self-efficacy and kinesiophobia. Response patterns were linked to the International Classification of Functioning Disability and Health (ICF) and analysed using principal component analysis (PCA) and partial least squares projections to latent structures (PLS). Result Patients were given the same treatment procedures irrespective of gender. The treatment procedures most often used were training of joint motion (48%), training of muscle functions and strength training (31%), massage (31%), physical treatment (28%), information about health/ill health (24%), and acupuncture (18%). Female and male physiotherapists used the same treatment procedures with a few exceptions. Female physiotherapists used treatment for mental functions and acupuncture more often than male physiotherapists. The women gave their patients a unique mixture of treatment procedures more frequently (43%) compared to their male colleagues (25%). Male physiotherapists used more training of joint motion. "To be confirmed" emerged as the core category when analysing interviews that considered expectations or experiences. Five categories were extracted: "To be taken seriously", "To get an explanation", "To be individually assessed and treated", "To be invited to participate", and "To be taken care of in a trustworthy environment". These were factors leading to confirmation. Two ideal types were identified: "confident" and "ambiguous". The "confident" did not doubt their right to health care and blamed their work for causing the pain. They related to a positive identity of strong or hard working. The "ambiguous" were afraid of being regarded as old, whining women and not being taken seriously. They were ashamed of having neck or back pain and blamed themselves; they thought they were not fit enough. The ideal types were not completely defined by gender, but more men were among the "confident" ideal type and more women were among the "ambiguous" type. Patients reacted differently to feelings of being confirmed or not, and this depended on whether they were the "confident" or "ambiguous" ideal type. The "confident" were satisfied and reacted with reorientation when they felt confirmed, even if they were not totally cured. When not confirmed, the "confident" reacted with anger, frustration, and feelings of shame or remained proud and blamed the health care personnel for being incompetent. The "ambiguous" also were satisfied and felt reoriented when they were confirmed. They then moved from being an "ambiguous" type to a more "confident" type. When the "ambiguous" were not confirmed in healthcare, they became dissatisfied and unhappy. They doubted the assessment, felt forlorn, and felt increased shame. Not being confirmed was experienced more negatively by women than by men irrespective of ideal type. Interesting information was found about how patients view their body in relation to pain during analysis of expectations and experiences in study II interviews. This led to Study III. In study III, "Fear of hurting the fragile body" emerged as an interview theme. Five categories supported or undermined beliefs about pain and physical activity: "The mechanical body", "Messages about activity", "Earlier experiences of pain and activity", "To be a good citizen", and "Support to be active". Patients thought their pain was due to tissue damage and viewed their bodies in a mechanical way. Clear messages from health care personnel about activity led to less fear of physical activity. Vague and contradictory messages led to more fear. Gender-stereotyped messages were given to patients. "The take it carefully" was such a message, and was more often to women when women were thought to be weak and in need of training. Another message was "Pain goes with heavy work". This message was more often given to men when men were thought to be strong and not in need of training. Earlier experiences of pain and activity could have been positive or negative. If positive, the experiences led to less fear of engaging in physical activity. A wish to be a good citizen, such as being a good parent, led to patients being more engaged in child care and playing more than they thought was good for their pain. Women, more than men, expressed avoidance of sick leave because they did not want to be a burden to society or to their work colleagues. Patients were anxious about how to do the "correct" exercises to avoid further injury. Practical support and a follow up to adjust the training program were important to reduce the fear of engaging in physical activity and to maintain motivation. One hundred and eighteen patients (84 women and 34 men) completed the questionnaire. PCA of all questions identified five significant components. The model explained 37% of the variance. The predictive power was 17%. PC1 explained 17% of the variance and the predictive power was 0.13%. PC1 was mainly explained by questions classified in ICF as Activity and Participation. These included questions about physical function and self-efficacy (classified as Content of Thought). Questions about support (classified as Environmental Factors) and stress reactions (classified as Body Function (Emotional Functions)) mainly explained PC2. PC3 was mainly explained by reported pain and symptoms from muscles (classified as Body Functions) and domestic work and leisure time activities (classified as Activity and Participation). There were differences in t-scores between women and men in PC2 (p=0.045) and PC3 (p=0.003). Variables that discriminated between women and men were questions about stress reactions and support at work in PC2, and questions about pain intensity and domestic work in PC3. Conclusion As a physiotherapist working with neck and back pain rehabilitation patients, it is important to be aware of both one’s own and the patient’s preconceptions about women and men. It is also important to be aware of the impact of gender on the professional role when choosing treatment procedures in order to ensure that choices will be based on evidence of effectiveness and not from stereotypes. Awareness of the patient’s individual needs and subsequent adaptation of treatments is also important. Some patients display a negative self-assessment and shame. They need more support to be able to reorient. Unless these patients are confirmed, they are at risk of prolonged disability. Gender stereotypes can hinder rehabilitation of neck and back pain if women are seen as weak and in need of protection and men are seen as strong and not in need of preventive muscle training. When assessing neck and back pain patients with questionnaires, gender has less significance than when asking questions about physical function and self-efficacy. Questions about emotions of stress reactions, support at work, and pain intensity contribute to gender differences for women. Questions on the level of domestic work contribute to gender differences for men.

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Rajballi, Ashmitha. "The relative effectiveness of homoeopathic Simillimum versus oral Traumeel? in the treatment of acute mechanical neck pain." Thesis, 2015. http://hdl.handle.net/10321/1431.

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Submitted in partial compliance with the requirements for the Master's degree in technology in Technology : Homeopathy, Durban University of Technology, Durban, South Africa, 2015.
Introduction There is no proper definition of acute mechanical neck pain (AMNP) but it has been theorized that it has a sudden onset pain and lasts for a relatively short time. It occurs with or without injury and presents with pain in the shoulder and upper arm. Acute mechanical neck pain should not be accompanied by an inflammatory disease, neurological disease, fracture, dislocation, neoplasm or infection AIM The purpose of this study was to compare the relative effectiveness of homoeopathic Simillimum against Traumeel® (a commercial homoeopathic complex) in the treatment of acute mechanical neck pain using the neck disability scale, range of motion measurements and a subjective observation. METHODOLOGY This study was a double blind, quantitative, comparative; clinical trial that involved two treatment groups: Half the participants received the homoeopathic Simillimum and the other half received oral Traumeel® drops. Patients self-selected homoeopathic treatment. Patients were screened and only those who fit the inclusion criteria of suffering from AMNP of maximal two weeks duration, were English conversant and between the ages of 18 and 55 were included. Those suffering with AMNP were required to sign an informed consent form after the procedure was explained thoroughly. Each patient read through the procedure of the clinical trial and were informed that their participation was on a voluntary basis and they could withdraw at any time. Convenience sampling was utilised in which an independent person, using a simple sampling method, randomly allocated the patients into the respective groups. Of the 30 patients, 15 received Traumeel® and 15 received homoeopathic Simillimum. It was hypothesized that the homoeopathic Simillimum treatment would be more effective in the treatment of acute mechanical neck pain than oral Traumeel®. The treatment protocol consisted of three homoeopathic consultations within a seven day period, with the consultations scheduled on days one, three and seven. Subjective and objective measurements were taken at each of the three consultations, Durban University of Technology Homoeopathic Day Clinic, Steve Biko Campus. A Simillimum treatment was prescribed for every patient based on full homoeopathic case history. This Simillimum was confirmed by the co-supervisor. Half of the patients were dispensed the Simillimum and the other half received Traumeel® according to the randomisation list. At the first follow up, on day three, the patients were reassessed according to their progress, perception and their range of motion, and the progress of the patient was analysed. In the last consultation on day seven, the progress of the patient was analysed using the perceptive questionnaire of the Neck Disability Index and the objective cervical range of motion. Full physical examinations were carried out during all three consultations. Upon collection of data, the statistical package SPSS 22.0 was used to record and analyse the data. Non parametric statistical tests were used as the data were non parametric - it does not follow any distribution, was ordinal (not relying on numbers but rather a ranking order of sorts). Inter-group comparisons were made using Mann-Whitney U-test. RESULTS The effectiveness of Traumeel® and homoeopathic Simillimum was measured firstly, in terms of the patients’ perception of the responses to the treatment applying the Neck Disability Index and secondly the increase in degree of movement in the range of motion of the cervical region. When applying an ANOVA with repeated measures with a Greenhouse-Geisser correction, the mean scores between groups were statistically not significantly different (p = 0.112). CONCLUSION Both the Traumeel® and Simillimum treatments were effective in the treatment of acute mechanical neck pain, but there was no evidence that one treatment was more beneficial than the other. The p-values (sig.) reported were greater than 0.05, thus implying that there is no significant difference between the groups.

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Bredenkamp, Debra. "The efficacy of an anthroposophical complex Disci comp. cum Argento® on cervical facet syndrome." Thesis, 2010. http://hdl.handle.net/10210/3139.

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M. Tech.
Cervical Facet Syndrome is a condition characterised by neck pain and decreased mobility of the cervical spine (Bovim et al., 1994). It is essentially the dysfunction of the posterior joints in the neck where muscle hypertonicity causes the ligaments to shorten (Gatterman, 1995). There is a high prevalence of Cervical Facet Syndrome in industrialised countries leading to a loss in productivity and costly expenditure in terms of treatment (Jordan et al., 1998). The aim of this research study was to assess the efficacy of treatment with injectables of the Anthroposophical medicine Disci comp. cum Argento on the symptoms of Cervical Facet Syndrome. These symptoms include pain and a decrease in range of motion. Pain was assessed using two questionnaires, namely the Visual Analogue Scale for Pain (Annexure D) and the Vernon Mior Neck Pain Disability Index (Annexure E). Range of motion was measured using the Cervical Range of Motion Goniometer (Annexure F). This was a double-blind, placebo-controlled trial. Thirty participants, male and female between the ages of 18 and 40 who had been pre-diagnosed with Cervical Facet Syndrome were recruited to participate in the research study. The study was conducted over a period of three weeks. On day one, participants were requested to complete a Consent Form (Annexure B), a Participant Profile (Annexure C), and the two questionnaires used to assess pain. Range of motion was measured by the researcher. The group was then randomly divided into two groups with 15 participants per group. The experimental group received subcutaneous injections of Disci comp. cum Argento and the control group received subcutaneous injections of saline. These injections were administered by the researcher and repeated three times a week for two weeks so that each participant received a total of six injections. A final assessment without treatment was completed in the third week. The two questionnaires and range of motion measurements were repeated at the third, sixth and seventh or final assessment. . The results of this study indicated that although both the remedy and placebo groups showed improvements, there was no significant difference in these improvements between the groups for the results obtained for the Visual Analogue Scale for Pain, Vernon Mior Neck Pain Disability Index and measurements of flexion, left rotation and left lateral flexion. There was however, significant differences in improvement between the visits in favour of the remedy group for measurements of extension, right rotation and right lateral flexion.

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Maboe, Mmapula Elizabeth. "The effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and the combination of the two in the treatment of chronic mechanical neck pain." Thesis, 2011. http://hdl.handle.net/10210/3832.

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M.Tech.
The aim of this study was to compare the effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and a combination of the two in the treatment of chronic mechanical neck pain. Forty-five patients were recruited via posters and advertisements from in and around the University of Johannesburg. The participants had to present with bilateral neck pain, decreased range of motion and an active levator scapulae muscles trigger point, which was diagnosed using range of motion and trigger point examination. The participants were randomly allocated into three groups of fifteen participants each. Prior to treatment a full case history, physical examination and cervical regional examination were performed to ensure that the patients were eligible to partake in the clinical trial. Group 1 was the adjusting group; group 2 was the combination group while group 3 was the needling group. Participants were treated five times over a period of three weeks. The objective measurements used in this clinical trial involved a cervical range of motion instrument (C.R.O.M., Performance Attainment Associates) and an algometer (Wagner Instruments). Subjective measurements were achieved using the Neck Pain and Disability Index (Appendix G) and the Numerical Pain Rating Scale (Appendix H). Each measurement was taken prior to treatment on the first and third visits and after treatment on the fifth visit with three measurements per participant overall. The statistical analysis was conducted using the Kruskal-Wallis, Friedman and Wilcoxon tests to compare data. The results indicated that the three groups responded favourably to their respective treatments. Overall, this study has indicated that dry needling of the Levator scapulae muscle provides no statistically significant contribution to the conservative treatment of mechanical neck pain caused by levator scapulae trigger points.

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Belling, Kym. "The relative effectiveness of the combination of spinal manipulation and Homoeopathic Simillimum in the treatment of chronic mechanical neck pain." Thesis, 2017. http://hdl.handle.net/10321/2569.

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Submitted in partial compliance with the requirements for the Master’s degree in technology in Technology: Homoeopathy, Durban University of Technology, Durban, South Africa, 2017.
Background: According to Picavet and Schouten (2003) the incidence of neck pain is increasing at a greater rate than other spine problems (Hoving et al. 2004). Furthermore, chronic neck pain is a substantial burden to society with chronic neck pain being the fourth leading cause of disability worldwide (Hoy et al. 2014). Chronic mechanical neck pain (CMNP) has been defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). Treatments for those suffering with chronic pain, which are non-surgical, appear to be the most beneficial for patients according to Haldeman et al. (2008). Giles and Müller (1999) have stated that spinal manipulation is the most effective method of treating spinal pain on its own. However, the literature suggests that there is benefit in combining manipulation with an “anti-inflammatory type” drug (Crawford 1988; Oberbaum 1998; Serrentino 2003). Many studies have been successfully conducted on Homoeopathic complexes to treat neck pain (Fisher 1986; Bohmer and Ambrus 1992; Hepburn 2000; Soeken 2004) however no study has yet to been carried out on the combination of Homoeopathic Simillimum (single remedy) and spinal manipulation for CMNP. Objective: The aim of this study was to determine if spinal manipulation and Homoeopathic Simillimum in combination are more relatively effective than spinal manipulation alone in the treatment of chronic mechanical neck pain. Methodology: This study was a randomised, blinded placebo controlled quantitative trial with a comparative clinical trial design. Thirty consenting participants with CMNP who met the inclusion criteria were randomly distributed between two treatment groups. Group A received spinal manipulation as well as Homoeopathic Simillimum and group B received spinal manipulation with placebo medication. Each participant received three treatments over a period of a week; with subjective and objective readings taken at every consultation. The subjective tools included the Numerical Pain Rating Scale and Canadian Memorial College of Chiropractic Neck Disability Index. Objective tools included the Algometer and CROM-II Goniometer. All data captured was analysed using SPSS version 24.0. Inferential and non-parametric analysis of the data were also be performed. Results: The results showed that no statistically significant differences were observed between the two groups in terms of subjective and objective measurements. However, there were statistically significant improvements seen in both groups equally in terms of ANOVA subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that no statistical or clinically significant changes were noticed between the groups and therefore the Homoeopathic Simillimum added no statistical significant improvements in those who received it over those participants who received placebo in the treatment of chronic mechanical neck pain.
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"A comparative study to determine the effectiveness of oral and parenteral Traumeel®S versus spinal manipulative therapy in the treatment of mechanical posterior neck pain." Thesis, 2009. http://hdl.handle.net/10210/2636.

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Van, der Velde Gabrielle. "Identifying the optimal treatment among common non-surgical neck pain treatments." 2008. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=742546&T=F.

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Parkin-Smith, Gregory Frederick. "The efficacy of spinal manipulative therapy in the treatment of mechanical neck pain." Thesis, 1996. http://hdl.handle.net/10321/1966.

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Dissertation submitted in the partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1996.
There have been few substantiated studies done to investigate the efficacy of spinal manipulative therapy for cervical syndromes [Vernon et.al. (1990: 13), Sloop et.al. (1982: 532) and Cassidy 1\ et. al. (1992: 495)]. Therefore, more conclusive evidence is needed to verify the success of manipulation, especially in terms of chiropractic treatment methods. The purpose of this investigation was to evaluate cervical spine manipulation and combined cervical and thoracic spine manipulation, according to subjective and objective clinical findings, in order to determine the efficacy of each approach in the management of mechanical neck pain. It was hypothesized that cervical spine manipulation, and combined cervical and thoracic spine manipulation would both be effective in the treatment of mechanical neck pain. However, it was proposed that combined cervical and thoracic spine manipulation would be more effective than just cervical spine manipulation, in terms of subjective and objective clinical findings. This study consisted of a controlled trial of a sample population diagnosed with joint dysfunction (cervical and thoracic facet syndrome) . Thirty subjects were randomly divided into two groups: the control group and the experimental group. The control group was treated with cervical adjustments only and the experimental group received combined cervical and thoracic adjusfments.
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Boodhoo, Vilash. "The efficacy of muscle energy technique in the treatment of chronic mechanical neck pain." Thesis, 2002. http://hdl.handle.net/10321/2099.

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Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2002.
The purpose of this study was to determine the efficacy of muscle energy technique in the treatment of chronic mechanical neck pain. This was a randomized placebo controlled study. Two groups of thirty subjects from Durban and the surrounding areas were selected to participate in the study, which was carried out at the Technikon Natal Chiropractic Day Clinic. Subjects were diagnosed with the condition by the researcher. Each subject received six treatments within a period of three weeks. Group A received muscle energy technique and de-tuned laser therapy applied to joint fixations. Group B received de-tuned laser therapy applied to the fixated areas. Subjective assessment was by means of the Short-Form McGill Pain Questionnaire and the Numerical Pain Rating Scale-101. Objective assessment was by means of the digital algometer (The Commander\x99 Algometer by Jtech Medical Industries) and the Cervical Range of Motion Device. Both the subjective and objective readings were taken prior to the first treatment and a day following the final (sixth) treatment.
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33

Rinke, Marike. "The effect of manual cervical traction versus mechanical cervical traction in the treatment of chronic neck pain." Thesis, 2014. http://hdl.handle.net/10210/9970.

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M.Tech. (Chiropractic)
Introduction: The most common chronic pain condition in modern society is neck pain (Jensen and Harms-Ringdahl, 2007). Chronic neck pain is a common complaint for many, from young patients to older patients with stressful work situations. According to Graham, Gross and Goldsmith (2006) neck disorders are common, disabling to various degrees and costly. Various structures in the cervical spine capable of transmitting pain include facet joints, intervertebral discs, nerve root dura, ligaments, and muscles (Manchikanti, Singh, Rivera and Pampati, 2002). According to Rochester (2009) chiropractors treat patients with chronic neck pain by using spinal manipulative therapy (SMT) to address a segmental joint hypomobility within the cervical spine as determined by joint motion palpation and endplay assessment. Traction is commonly used for the treatment of the spine by various physical therapists. It may be included as part of a chiropractic treatment protocol. According to Hooper (1996) traction involves the application of both manual and mechanical forces to draw adjacent body parts away from each other resulting in decompressed irritated tissues, realign parts, and relaxing tight structures. There are several types of cervical traction. The short and medium term improvement for chronic neck pain as well as the comparative effect of manual cervical traction versus mechanical cervical traction in combination with spinal manipulative therapy has not yet been established. Aim: This particular research study aimed to compare the short to medium term efficacy of manual cervical traction with mechanical cervical traction combined with spinal manipulative therapy with regards to decreased pain and improvement of cervical spine ranges of motion in patients with chronic neck pain. Methodology: Participants who met the inclusion and exclusion criteria were eligible to participate in this study. Advertisements were placed on notice boards around the campus of the University of Johannesburg and participants were recruited from the use of advertisements as well as word of mouth to partake in this research study. Thirty participants who suffered from chronic neck pain, volunteered for this comparative research study. This study was a randomized comparative study, where participants were randomly selected to be either in Group 1 or in Group 2. Group 1 received manual cervical traction whereas Group 2 received mechanical cervical traction. Both groups received spinal manipulative therapy to the restricted motion segments found in the cervical spine. Participants received seven trial sessions, with six treatments, over a period of two weeks. At the final 7th visit, one month after the sixth visit, no treatment was performed. Subjective and objective measurements were recorded at each visit. The subjective measurements of this particular study consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon-Mior Neck Disability Index to evaluate the participants’ sensitivity to pain and disability. The objective measurements of this study included the Cervical Spine Range of Motion instrument to assess the participants’ cervical spine movement. Results: Both groups demonstrated a statistically significant improvement over time with regards to pain and disability, as well as increased range of motion to the cervical spine. The greatest percentage improvement with regards to range of motion was in lateral flexion and rotation of the cervical spine. Conclusion: According to the results of this study, it could be concluded that either manual cervical traction or mechanical cervical traction in combination with spinal manipulative therapy can be used effectively in the treatment of chronic neck pain as part of a chiropractic treatment protocol. Both groups proved to have a statistically significant improvement with regards to pain and disability as well as increased cervical spine range of motion...

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Meyer, Elsje Maria. "A comparison of mobilisation and exercise in the treatment of chronic non-specific neck pain." Thesis, 2014. http://hdl.handle.net/10321/964.

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Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Durban University of Technology, 2013.
Background : Chronic non-specific neck pain is a common condition that negatively affects cervical muscle functioning and activities of daily living. Combined exercise and mobilisation are currently recommended as the most effective treatment for this condition. Mobilisation, such as mobilisation of the cervical spine, provides short-term pain relief and affects neural activity, while the craniocervical flexion exercise provides immediate pain relief and activates the deep cervical flexors. The short-term effect of mobilisation and the craniocervical flexion exercise have not been compared. Objectives : This study aimed to compare mobilisation and craniocervical flexion exercise in terms of subjective and objective outcome measures at a short-term follow-up consultation for the treatment of chronic non-specific neck pain. The null-hypothesis was that the mobilisation group would not respond differently to the craniocervical flexion exercise group. Method : A group of thirty females between the ages of 20 and 35 complaining of non-specific neck pain for more than three months were randomly allocated into either the mobilisation or craniocervical flexion exercise groups. During the first two consultations, a mobilisation was administered to the mobilisation group. Whereas the craniocervical flexion exercise and a posture correcting exercise were taught to the participants of the craniocervical flexion exercise group. The Numerical Pain Rating Scale, Neck Disability Index, Neck Bournemouth Questionnaire, cervical range of motion and algometer readings were taken at each of the three consultations. The Patient Global Impression of Change Scale was administered at the last consultation one week after the first consultation. Results : Both the mobilisation and craniocervical flexion exercise groups showed significant improvements in all of the subjective outcomes. The Neck Disability Index score of the craniocervical flexion exercise group was the only subjective outcome that did not decrease enough to be considered clinically significant. The PGIC score of the mobilisation group was slightly higher than that of the craniocervical flexion exercise group. There was no statistically significant improvement in the objective outcomes of either group. All ranges of motion decreased in both groups, while pain pressure threshold improved in both groups. There was no significant difference between the results of the subjective and objective outcomes of the mobilisation and craniocervical flexion exercise groups. Conclusions and recommendations : The two interventions were found to have a similar effect in the treatment of chronic non-specific neck pain in terms of subjective and objective outcome measures. Participants of both groups indicated on the subjective scales that their conditions improved, even though objective outcomes showed no significant change. In future studies, a larger sample size should be used and the sample should be stratified for ethnicity to increase validity of the results.

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Camitsis, Aaryn. "The effect of craniocervical flexion exercise on cervical posture and cervical range of motion in asymptomatic participants." 2015. http://hdl.handle.net/10321/1210.

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Dissertation submitted in partial compliance with the requirements for the Master’s degree in technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2013.
Background: Forward head posture (FHP) is a common postural abnormality that is commonly associated with weak deep cervical flexor muscles (DCF). The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting the C7 spinous process to the tragus of the ear. The smaller the angle, the greater the forward head posture. Weak DCF musculature and FHP has been linked to cervical dysfunction in the short and long term such as cervicogenic headache and premature development of cervical regional degenerative joint disease. Improving isometric endurance and neuromotor control of the DCF muscles using craniocervical flexion exercise (CCFE) has been shown to be efficient in patients experiencing cervical dysfunction such as headache, although the relevance of CCFE has not been established in the asymptomatic group. Deficiency in the activity of these muscles can be accurately measured using craniocervical flexion testing (CCFT). There is a paucity of information regarding the definitive relationship between weakness of the DCF and FHP in asymptomatic participants. This research will help establish an efficient and safe prophylactic treatment protocol preventing long term sequela associated with FHP. Objectives: To determine the effect of CCFE on cervical posture by assessment of the CV angle in asymptomatic participants as well as to determine the effect of CCFE on cervical range of motion by assessment of flexion, extension, bilateral rotation and lateral flexion movements in asymptomatic participants whilst measuring the effect of CCFE on isometric endurance and neuromotor control of the DCF muscles assessed by the CCFT in asymptomatic participants. Method: This is a quantitative pre/post intervention study comparing the results of one group of 45 asymptomatic participants before and after the CCFE protocol has been allocated to them over a period of 3-5 weeks. Participants FHP was assessed by measuring the CV angle. This was done by marking the C7 spinous process and extending a horizontal line toward the shoulder. Then marking the tragus of the ipsilateral ear and measuring the angle using the smart tool angle finder (MD products). iv CCFT measurements were taken and the CCFE protocol allocated to those who qualified to take part in the study. Lastly, cervical range of motion was measured. This group received a home exercise protocol of 3 sets of 10 supine chin tucks daily with each repetition being held for 10 seconds. The technique was first ensured by the researcher prior to leaving the consultation rooms and an exercise diary was given to the participant until the 5th and final consultation to record the progress and efficiency of the home programme as well as any complaints regarding this. Result: The asymptomatic group included in the study improved in both the seated and standing CV angle measurements in that the CV was greater at the conclusion of the pre/post intervention (p=0.00000002) and (p=0.000003) respectively . Cervical range of motion showed improvement in some but not all ranges. Flexion showed a reduction in range of motion (p=0.0086) which was significant. Extension showed an improvement in range of motion (p=0.0000002) which was significant. Rotation toward the left (p=0.00003) and right (p=0.00063) showed an improvement in range of motion which was significant. Lateral flexion showed improvement which was not significant in both, left (p=0.0145) and right (p= 0.24985) ranges of motion. Neuromotor control showed 100 percent improvement in that all 45 of the participants were able to perform CCFT correctly through all five stages at conclusion of the study. Conclusion: Therefore it can be concluded that asymptomatic participants will benefit from CCFEs In terms of CV angle improvement, cervical range of motion as well as neuromotor control of the DCF muscles.

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Chen, Jen-Yu, and 陳人毓. "Effectiveness Of Stepwise Integrated Manual Therapy In The Treatment Of Neck Pain." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/63272175122406363892.

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碩士
臺北巿立體育學院
運動科學研究所
100
Neck pain is one of the most common problems in health care, and significantly contributes economic burden in modern society. Evidence suggests the use of non-operative manual intervention and multimodal approach for the treatment of neck pain. The purpose of this study was to examine the effects of stepwise integrated manual therapy in patients with a primary complaint of neck pain. The integration of manual therapy in this study and operated through steps are soft tissue inhibitory technique, resisted isometric technique and thrust manipulation technique. Subjects of this study were from society or company in Taipei. They were eligible for the study if they had neck pain and the numeric pain rating scale (NPRS)≧2. Thirty-five subjects were recruited consecutively in this study and randomly assigned to treatment group or control group. There were twenty subjects arranged to treatment group, and fifteen to control group. After the baseline assessment and test, subjects were received our manual therapy. The experimental group received integrated manual therapy included soft tissue inhibitory technique for tender-points, resisted isometric technique to facilitate muscle contraction and twice thoracic spine thrust manipulation technique step by step. The control group received sham intervention, using light touch instead of inhibition and non-resistance of facilitation than sham manipulation of thoracic spine. Data were obtained before and after each treatment, including numeric pain rating scale, neck active range of motion (flexion, extension, left lateral flexion, right lateral flexion, left and right rotation) and five minutes electro-cardiac monitor. The results showed that after manual therapy, the difference of neck pain score was significantly reduced in the experimental group compared to the control group (p<0.0005). According to the change of cervical range of motion, the experimental group was significantly increased after manual therapy. The difference of general dimensions of cervical spine was significantly increased in the experimental group compared to the control group (p<0.0005). In addition, after the treatment there were significant difference between experimental group and control group in left lateral flexion and right lateral flexion (p=0.02, p=0.04). In the data transferring from electro-cardiac monitor, there was significant difference in the mean of heart rate interval, total heart beats and heart rate (p<0.0005, p=0.004, p<0.0005). In the self-measuring score of global rating of change also showed that subjects of experimental group feel moderate improvement after treatment, while control group feel no or little change. Stepwise integrated manual therapy can relief pain and regain neck mobility effectively. It is a kind of fast, safe and effective way to treat neck pain. We suggest using this method to protect athlete. Through the well-trained operator, can provide the athlete to cure pain and enhance competition performance.

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Wang, Hsiao-Lan. "Shoulder Pain after Neck Dissection among Head and Neck Cancer Patients." Thesis, 2009. http://hdl.handle.net/1805/1995.

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Indiana University-Purdue University Indianapolis (IUPUI)
Shoulder pain was constantly reported as a problematic symptom causing dysfunction and quality of life interference after neck dissection in head and neck cancer patients. Due to a lack of conceptual framework and inconsistency of instrument selection, a comparison among previous studies was almost impossible, making it difficult to understand the phenomenon. The current study applied the University of California, San Francisco School of Nursing Symptom Management Model. The purposes of the study were to (a) describe the symptom experience of shoulder pain at 1 month after neck dissection, (b) describe the relationships among symptom experience of shoulder pain, functional status, and quality of life, and (c) identify the contextual variables, concurrent symptoms, and/or adherence predicting symptom experience of shoulder pain, functional status, and/or quality of life. This was a descriptive study with a convenience sample of head and neck cancer patients. The data were collected via a medical record review, a self-administered survey, and a physical examination. The data from 29 patients were entered for descriptive statistics, Pearson correlations, and multiple regressions. At 1 month after surgery, 62% of patients reported they had shoulder pain at some point within a week. Their shoulder pain was from mild to moderate. Fifty-nine percent complained that shoulder pain bothered them about the moderated level. In the final model, symptom experience, shoulder pain, was significantly correlated with one outcome, active shoulder abduction, but not the other, total quality of life, generic quality of life, and head and neck quality of life. Active shoulder abduction was significantly correlated with three quality of life measures. Adding significant predictors of symptom experience and outcomes into the final model, there is a potential that the model would be useful to guide treatment strategies. Treatment for myofascial pain of the levator scapulae could relieve shoulder pain after neck dissection and improve head and neck quality of life. Those with level V dissection were high risk populations of developing shoulder pain. Risk factors of quality of life, which were depression, loss of sensation, and radiation would describe how an intervention could change or unchange the patient’s life.

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Reed, Pauline. "The effect of chiropractic manipulation versus mobilisation on pressure pain threshold in chronic posterior mechanical cervical spine pain." Thesis, 2012. http://hdl.handle.net/10210/7857.

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M.Tech.
Purpose: This study aims to compare the effects of chiropractic manipulation versus mobilisation on Pressure Pain Threshold in chronic posterior mechanical cervical spine pain sufferers with regards to pain, disability and cervical spine range of motion. These effects were evaluated using a questionnaire consisting of a McGill Pain Questionnaire, and a Vernon – Mior Neck Pain and Disability Questionnaire, and by measuring cervical spine range of motion using a Goniometer as well as Algometer readings over the restricted facet joint/s in the cervical spine. The questionnaires were completed and the range of motion readings and algometer readings were taken prior to treatment on the first, fourth and seventh consultations. Method: Thirty participants who met the inclusion criteria were divided into two groups of equal size (15 participants each). Group one received spinal manipulation to restricted cervical spine joint/s. The second group received spinal mobilisation to restricted cervical spine joint/s. Participants were treated six times out of a total of seven sessions, over a maximum three week period. Procedure: Subjective data was collected at the beginning of the first and fourth consultations, as well as on the seventh consultation by means of a McGill Pain Questionnaire, and a Vernon – Mior Neck Pain and Disability Questionnaire in order to assess pain and disability levels. Objective data was collected at the beginning of the first and fourth session, as well as on the seventh consultation by means of a Goniometer and Algometer in order to assess cervical spine range of motion and to measure the Pressure Pain Threshold at the restricted facet joint/s in the cervical spine. Analysis of collected data was performed by a statistician. Results: Clinically significant improvements in group 1 and group 2 were noted over the duration of the study with reference to pain, disability, and cervical spine range of motion. Statistically significant changes were noted in group 1 and group 2 with reference to pain and disability, and in group 1 and group 2 with v reference to certain cervical spine range of motions as well as algometer readings to measure the Pressure Pain Threshold at the restricted facet joint/s. Conclusion: The results show that both spinal manipulation and mobilization are effective treatment protocols (as demonstrated clinically, and to a lesser extent, statistically) in decreasing pain and disability, and increasing cervical spine range of motion and most importantly Pressure Pain Threshold at the restricted facet joint/s in patients with chronic posterior mechanical cervical spine pain. Although the study did not allow for a definite conclusion to be drawn, the results suggest that Chiropractic manipulative therapy is an effective treatment protocol to increase the Pressure Pain Threshold in chronic posterior mechanical neck pain sufferers. The advantage of this is that the treatment modality is used to its full potential, thereby providing the patient with the best results in terms of lasting benefits. It also shows that in cases where manipulation is contra-indicated mobilization will have a similar effect, but the long term benefits are questionable.

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Cacace, Hanna. "Alternative opioid-sparing treatment options for acute pain management therapy." Thesis, 2018. https://hdl.handle.net/2144/31158.

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The vast array of causes, mechanisms, and interventional strategies for pain has created an extensive field of research spanning a variety of disciplines. This thesis aims to describe the multidimensional factors leading to pain, how pain can be assessed, and how we can best target these pain pathways to improve acute pain management. Although opioids have been used for centuries in many analgesic therapies, new research and public concern are increasingly deterring clinicians from prescribing them. This thesis will discuss opioid's mechanism of action, risk of adverse effects, and limitations. Furthermore, the 'opioid crisis' will be examined from its beginning to where we are now. Alternative pharmacological and nonpharmacological therapeutic options are presented in the hope of exposing opioid-sparing improvements to analgesia; their mechanism of action, efficacy, and limitations are described where applicable. Beyond individual analysis and evaluations of reputable, highly cited studies for each therapeutic option, this thesis also examines multimodal analgesia and how it is changing acute pain management. Multimodal analgesia allows multiple dimensions of the pain pathway to be targeted by using multiple drugs, leading to greater pain relief, decreased doses of medications, and reduced side effects. Multidisciplinary advantages are also discussed, including dynamic clinician involvement, individualization, organizational procedures, and patient education interventions. The complexities of pain management therapy and suggestions for future directions presented in this thesis are intended to expose additional options or techniques to ultimately improve surgical outcomes, increase patient satisfaction, and decrease public health risks.

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40

Scott-Dawkins, Craig Anthony. "The comparative effectiveness of adjustments versus mobilisation in treating mechanical neck conditions." Thesis, 1996. http://hdl.handle.net/10321/2768.

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A dissertation presented to in partial fulfilment of the requirements for the Masters Degree in Technology: Chiropractic, Technikon Natal, 1996.
The aim of this study was to determine the effectiveness of adjustments versus mobilisation in the treatment of mechanical neck pain. It was hypothesized that treatment with adjustments over a three week period, with a further three week follow-up period, would be more effective than mobilisation in terms of improving the patients' cervical ranges of motion and their perceptions of pain and disability.
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Mudditt, Jonathan. "Spinal manipulative therapy and MYO₂ for the treatment of posterior mechanical neck pain." Thesis, 2013. http://hdl.handle.net/10210/8317.

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M.Tech. (Chiropractic)
Purpose: The aim of this study was to look at the effectiveness of massage with MYO₂ gel in conjunction with Spinal Manipulative Therapy (SMT) for the treatment of patients with posterior mechanical neck pain, with regards to pain, disability and cervical spine range of motion. The effect of these treatments was evaluated using a questionnaire consisting of Visual Analogue Scale (VAS) and a Vernon-Mior Neck Pain and Disability Index Questionnaire, and by measuring cervical spine range of motion using a cervical range of motion (CROM) measuring device. Method: 30 participants with posterior mechanical neck pain were randomly divided into two groups based on the order they start the study in. Group A – control group, received SMT to the cervical spine, followed by massage with ultrasound gel over the upper trapezius muscle and the area of the posterior neck musculature. Group B – experimental group, received SMT of the cervical spine, followed by massage with MYO₂ gel over the upper trapezius muscle and the area of the posterior neck musculature. Participants were treated six times out of a total of seven sessions, over a maximum three week period. Procedure: Subjective data was collected at the beginning of the first and fourth and seventh consultations. This was done by means of a Visual Analogue Scale (VAS) and a Vernon- Mior Neck Pain and Disability Index Questionnaire in order to assess pain and disability levels. Objective data was collected at the beginning of the first, fourth session, and seventh consultation by means of measuring cervical spine range of motion using a cervical range of motion (CROM) measuring device. Analysis of collected data was performed by a statistician from STATKON; a department of the University of Johannesburg. Results: When comparing the VAS of the initial with the final consultation it showed a statistically significant difference in both groups. This indicated that both interventions were effective in decreasing the perceived level of neck pain (VAS score). When comparing the Neck Pain and Disability Index of the initial with the final consultation it showed a statistically significant difference in both groups. This indicated that both interventions were effective in decreasing neck pain and disability of the cervical spine. When comparing the Cervical Range of Motion (CROM) of the initial consultation with the final consultation it showed a statistically significant improvement in both groups in all directions of motion. Both groups resulted in an increase in range of motion over time. Group B had a greater average CROM percentage increase of 28.60% average compared to Group A which had an average percentage increase of 22.25%.

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Panagis, Lana. "Chiropractic manipulative therapy and proprioceptive neck exercises for the treatment of chronic mechanical neck pain and its effect on head repositioning accuracy." Thesis, 2013. http://hdl.handle.net/10210/8767.

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M.Tech. (Chiropractic)
Mechanical neck pain is the most common type of cervical spine pain encountered. It is also referred to as simple or non-specific neck pain and is common in all groups of people (Plaugher, 1993). A majority of individuals with neck pain do not experience a resolution in their pain and disability and this thus results in chronicity (Cote, Cassidy, Carrol and Kristman, 2004). Chiropractic manipulative therapy (CMT) is a specific form of articular manipulation, especially of the vertebral column. This is performed either manually, mechanically, actively or passively in order to restore normal articular alignment and function (Gatterman, 2005). Proprioceptive neck exercises are designed to retrain the cervical musculature to regain its position sense in space. Specific exercises are designed to locate the head to a neutral position and then to do a series of movements in other planes, and then to return the head to the neutral position (Revel, Minguet, Gergoy, Valliant and Manuel, 1994). Chiropractic manipulative therapy does have documented positive effects on the proprioceptive system within the cervical spine (Palmgren, 2006) as does proprioceptive exercises (Sarig-Bahat, 2003; Revel, Minguet, Gergoy, Vaillant, Manuel, 1994). The desired effects of combining both these treatments would be to increase the response rate in patients suffering from chronic mechanical neck pain. The aim of this study was to compare the effects of Chiropractic manipulative therapy (CMT) and proprioceptive neck exercises as stand-alone treatment protocols, as well as a combination treatment protocol with regards to neck pain, disability, cervical spine range of motion and Head Repositioning Accuracy (HRA). Participants were recruited from the University of Johannesburg Chiropractic Day Clinic. They were eligible to participate in the study once they met the inclusion and exclusion criteria. Participants were recruited by means of advertisements that were placed around the respective campuses of the University of Johannesburg as well as by word of mouth. Thirty participants, who presented with chronic mechanical neck pain, volunteered for this randomised comparative clinical study. The participants, aged between 18 - 40, were randomly divided into three groups of ten, with a half female to male ratio. Group 1 received Chiropractic manipulative therapy to the restricted joints in the cervical spine, Group 2 received proprioceptive neck exercises and Group 3 received a combination of both treatments. Participants were treated for a total of 6 visits over a three week period. Subjective and objective measurements were taken at the beginning of visits 1, 4 and at a final visit 7 during which only measurements were taken. Subjective measurements consisted of the Vernon-Mior Neck Pain and Disability Index (VMNPDI) and the Numerical Pain Rating Scale (NPRS) to assess the participants‟ neck pain and disability as well as their perception of pain. Objective measurements were obtained by using the Cervical Range of Motion device (CROM) as well as measuring the Head Repositioning Accuracy (HRA) as described by Revel, Andre-Deshays and Minguet (1991). Based on the results of the study, it could be concluded that both Group 1 (Chiropractic manipulative therapy to the restricted joints in the cervical spine) and Group 3 (a combination of cervical spine manipulation and proprioceptive neck exercises) can be used effectively to treat chronic mechanical neck pain and improve HRA. Group 1, 2 and 3 showed statistical improvements in certain areas and clinical improvements in all areas over time. It could not be statistically concluded whether one treatment is superior to the other, although clinically, Group 1 and Group 3 seemed to be more effective. Considering that Group 3 is a combination of cervical spine manipulation and proprioceptive neck exercises, it could be considered as a valid treatment protocol for chronic mechanical neck pain and improving HRA and could thus be used in a clinical setting.

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"The immediate effect of NeuroTrac® MultiTENS on acute neck pain." Thesis, 2015. http://hdl.handle.net/10210/14028.

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M.Tech. (Homoeopathy)
Neck pain is a common condition usually experienced due to mechanical or degenerative problems (Colledge et al., 2010). The onset of neck pain may be acute and associated with asymmetrical restriction of neck movements and a history of awkward posture or sudden onset. Acute neck pain is an aching pain in the cervical paraspinal muscles and ligaments. It is associated with muscle spasm, stiffness and tightness in the upper back and shoulders that lasts up to six weeks. Headaches may be present (Bickley & Szilagyi, 2009). Causes of neck pain can be mechanical, inflammatory, metabolic, neoplastic, due to referred pain or other underlying aetiologies (Colledge et al., 2010). The most common treatments for neck pain are nonsteroidal anti-inflammatory drugs, physiotherapy, chiropractic adjustment or therapeutic massage (Taylor, 2010). The NeuroTrac® MultiTENS device provides a non-invasive, drug-free method of controlling acute pain by transmitting mild electrical impulses via surface electrodes through the skin (Verity Medical Ltd., 2013). There have been many studies done on Transcutaneous Electrical Nerve Stimulation (TENS) devices, but little on its immediate effect on acute neck pain. The aim of this study was to determine the immediate effect of the NeuroTrac® MultiTENS device on acute neck pain, using the Neck Pain Disability Index, Visual Analogue Scale and the Cervical Range of Motion (CROM). This study was an unblinded, single-group experimental design (Brink, 2010). The study took place at the University of Johannesburg Campus Clinic. Recruitment took place by means of advertisements (Appendix H) placed at the University of Johannesburg campuses. Inclusion criteria consisted of males and females between the ages of eighteen to fifty years. Participants had to be suffering from aching pain in the cervical paraspinal muscles and ligaments with associated muscle spasm, stiffness and tightness in the upper back and shoulders that was present for more than one day and no longer than one week, with decreased range of motion on CROMs (Appendix G) and a minimum score of 10 on the Neck Pain Disability Index (Appendix D). Exclusion criteria consisted of participants suffering from severe headaches with meningeal signs associated nausea, blurred vision, photophobia and phonophobia or fever; a history of thrombus formation or transient ischaemic attack (Longmore et al., 2010); if they had a pacemaker or if they have had any head and neck surgery; if they suffered from cardiac arrhythmia or myocardial infarction; pregnancy or suspected pregnancy; if they had a general skin sensitivity or known allergy to adhesives or if they have had a recent chiropractic adjustment. A total of forty participants were selected. The participants acted as their own baseline control. The researcher was only required to see participants once for one forty minute session to determine the immediate vi effect of the NeuroTrac® MultiTENS device on acute neck pain. Participants were asked to fill in an Information (Appendix A) and Consent Form (Appendix B). Participants came in for an initial consult where a history was taken on the type of neck pain experienced and the cause of the pain experienced. Vital signs were recorded on a case taking form (Appendix C). Thereafter participants were asked to fill in the Vernon and Mior Neck Pain Disability Index (Appendix D) relating to the neck pain they experienced and to complete a Visual Analogue Scale to rate their neck pain (Appendix F). The CROM goniometer device was placed on the participant’s head to measure all cervical spine ranges of motion, to the limit of pain (Appendix G). All forty participants received treatment at a frequency of 90Hz with a 200μS pulse width with the electronic pads placed on the shoulders. NeuroTrac® MultiTENS device treatment was administered for forty minutes to the participants in a seated position. The treatment was administered by the researcher. Once the treatment ended, participants were asked to fill in an amended questionnaire (Appendix E) that assessed if they noticed a change in the neck pain they were experiencing, to complete the Visual Analogue Scale (Appendix F) and their vital signs were again recorded on a case taking form (Appendix C). The CROM goniometer device was again placed on the participant’s head to measure all cervical spine ranges of motion to assess if there was a change in the readings recorded (Appendix G). The data obtained was statistically analysed by the researcher with the aid of a statistician at Statkon. The Shapiro-Wilk test and the Wilcoxon Signed-Rank test (non-parametric test) were used (Van Staden, 2014) ...

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"The effect of post-manipulative mobilization in the chiropractic management of chronic mechanical neck pain." Thesis, 2009. http://hdl.handle.net/10210/2645.

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Allwood, Tracey Elaine. "The effectiveness of manipulation combined with a cervical pillow compared to manipulation alone in the management of mechanical neck pain." Thesis, 2001. http://hdl.handle.net/10321/1842.

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Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001.
Neck pain is a common condition that has become a serious health concern. Since there is controversy regarding the most effective management of this condition, further research needs to be executed. The purpose of this investigation was to compare manipulation combined with a cervical pillow to manipulation alone in the management of mechanical neck pain. The rationale behind this, was that manipulation is one of the most common treatments for spinal conditions and has shown significant results in alleviating mechanical neck pain. Cervical pillows have been investigated by various researchers. They have concluded that cervical pillows are effective in treating mechanical neck pain. Thus, using the pillow as an adjunct to manipulation should attain superior results to manipulation alone. This study consisted of 40 patients who were randomly divided into 2 equal groups. The average age of the patients was 34 years old and the average duration of neck pain was pain of greater than 6 months. The patients received 6 treatments over a 4 week period. Group1 were manipulated and given a cervical pillow to sleep on, while group 2 received manipulation alone.
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Alivizatos, Jarrod. "The effect of osteopathic treatment on people with sub-chronic and chronic neck pain." 2004. http://eprints.vu.edu.au/741/1/Alivizatos_et.al_2004.pdf.

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Background and Objectives: Neck pain can be severely disabling and costly, it is a common problem in the general population with point prevalence ranging between 10% and 15%. The aim of this single cohort study was to investigate if osteopathic management of neck pain would reduce patients' perceived pain. Conclusion: Both outcome measures demonstrated a significant reduction in the perceived quality and intensity of neck pain with osteopathic management. This pilot study suggests that osteopathic treatment is effective for the management of neck pain. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

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Lamaro, Josh. "The effect of osteopathic treatment on people with chronic and sub-chronic neck pain." 2004. http://eprints.vu.edu.au/847/1/Lamaro_et.al_2004.pdf.

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Neck pain is a common problem within our society, and can be severly disabling and costly to the sufferer. The aim of this single cohort study was to investigate the effect of osteopathic management of sub-chronic and chronic neck pain on perceived pain and disability. Seventeen participants (7 male, 10 female) who had experienced intermittent or constant neck pain for a duration of longer than one month were included in this study. The participants were offered a four-week course of osteopathic treatment at the Victoria University Osteopathic Medicine Clinic and were treated by senior osteopathic students using a semi-standardised treatment protocol. A Visual Analogue Scale (VAS), and Neck Disability Index (NDI) were completed prior to the initial treatment and after treatments on weeks 2 and 4. Perceived intensity of neck pain, and perceived disability significantly reduced following four weeks of osteopathic management. This pilot study suggests that osteopathic treatment is effective for the management of chronic and sub-chronic neck pain. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

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Harpham, Graeme John. "The relative effectiveness of manipulation versus a combination of manipulation and oral Traumeel S in the treatment of mechanical neck pain." Thesis, 2005. http://hdl.handle.net/10321/282.

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Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2005. xii, 51 leaves : ill. (some col.) ; 30 cm
According to the recent literature the application of non-steroidal anti-inflammatory drugs (NSAIDS) is the mainstay and first line of conventional treatment for many types of pain, including that of spinal origin (DiPalma and DiGregorio 1994; Dabbs and Lauretti 1995; Koes et al. 1997). NSAID therapy has inherent side effects (Goodman and Simon 1994), however, given the risks involved, they are still of value as an adjunct to spinal manipulation (Crawford 1988), which has been shown to have less side effects and be more effective than conventional NSAIDS (Dabbs and Lauretti 1995; Giles and Müller 1999). A homeopathic alternative to NSAIDS is Traumeel S, it fulfils all the criteria for a locally acting therapeutic medication, with promotion of the natural healing process, and minimum side effects (Zell et al. 1989). A study by Hepburn (2000) compared the relative efficacy of Traumeel S against NSAIDS in the treatment of cervical facet syndrome. Hepburn concluded that there was statistically no difference between the two therapies. It could therefore be inferred that Traumeel S may be a valid alternative to NSAID therapy in the treatment of cervical facet syndrome. This study tested this hypothesis by comparing the effectiveness of spinal manipulation with the concurrent administration of oral Traumeel S against spinal manipulation alone in order to assess the potential benefit of combining Traumeel S with manipulation.

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Wilson, Laura Maie. "The short to medium term effectiveness of proprioceptive neuromuscular facilitation stretching as an adjunct treatment to cervical manipulation in the treatment of mechanical neck pain." Thesis, 2002. http://hdl.handle.net/10321/272.

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Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2002 xiii, 93 leaves
The purpose of this study was to determine the short to medium term effectiveness of Proprioceptive Neuromuscular Facilitaion (P.N.F.) stretching [using the Contract- Relax-Antagonist-Contract (C.R.A.C.) technique] as an adjunct treatment to cervical manipulation in the treatment of Mechanical Neck Pain.

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Brown, Colin Douglas. "The effectiveness of first rib adjustment as an adjunct to the treatment of mechanical neck pain." Thesis, 2006. http://hdl.handle.net/10321/338.

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Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. 130 leaves.
The purpose of this investigation was to evaluate the efficacy of the adjustment of the first rib as an adjunct to the manipulative treatment of mechanical neck pain, according to subjective and objective clinical findings. The results of this study would indicate to Chiropractors which specific types of adjustments, used for the treatment of mechanical neck pain, would potentially increase the cervical range of motion and / or decrease pain experienced by the patient and thus lead to a more effective treatment protocol. The outcome of the study will help clinicians select the more appropriate treatment for patients based on the subjective and objective outcomes.

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Dissertations / Theses on the topic 'Neck pain – Alternative treatment'

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