Borenstein David G
Arthritis and Rheumatism Associates, The George Washington University Medical Center, 2021 K Street NW, Suite 300, Washington, DC 20006, USA.
Curr Pain Headache Rep. 2007 Dec;11(6):436-9. doi: 10.1007/s11916-007-0230-4.
Chronic neck pain is a common patient complaint. Despite its frequency as a clinical problem, there are few evidence-based studies that document efficacy of therapies for neck pain. The treatment of this symptom is based primarily on clinical experience. Preventing the development of chronic neck pain can be achieved by modification of the work environment with chairs that encourage proper musculoskeletal movement. The use of neck supports for sleep and active neck exercises together can improve neck pain. Passive therapies, including massage, acupuncture, mechanical traction, and electrotherapy, have limited benefit when measured by clinical trial results. NSAIDs, muscle relaxants, and pure analgesics are the mainstays of therapy. Local injections of anesthetics with or without soluble corticosteroid preparations offer additional pain relief. The purpose of these agents is to diminish pain to facilitate normal neck movement. Surgical therapy with cervical spine fusion is indicated for the rare patient with intractable neck pain resistant to all nonsurgical therapies.
慢性颈部疼痛是患者常见的主诉。尽管它作为一个临床问题很常见，但很少有基于证据的研究记录颈部疼痛治疗方法的疗效。这种症状的治疗主要基于临床经验。通过使用鼓励适当肌肉骨骼运动的椅子来改善工作环境，可以预防慢性颈部疼痛的发生。睡觉时使用颈部支撑物并结合积极的颈部锻炼可以改善颈部疼痛。通过临床试验结果衡量，包括按摩、针灸、机械牵引和电疗在内的被动疗法益处有限。非甾体抗炎药、肌肉松弛剂和单纯镇痛药是治疗的主要手段。局部注射麻醉剂（有无可溶性皮质类固醇制剂）可进一步缓解疼痛。这些药物的目的是减轻疼痛，以促进颈部正常活动。对于极少数对所有非手术治疗均无效的顽固性颈部疼痛患者，可采用颈椎融合手术治疗。
