Kjaer Per, Kongsted Alice, Hartvigsen Jan, Isenberg-Jørgensen Alexander, Schiøttz-Christensen Berit, Søborg Bolette, Krog Charlotte, Møller Christian Martin, Halling Christine Marie Bækø, Lauridsen Henrik Hein, Hansen Inge Ris, Nørregaard Jesper, Jørgensen Karsten Juhl, Hansen Lars Valentin, Jakobsen Marie, Jensen Martin Bach, Melbye Martin, Duel Peter, Christensen Steffan W, Povlsen Tina Myung
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.
Eur Spine J. 2017 Sep;26(9):2242-2257. doi: 10.1007/s00586-017-5121-8. Epub 2017 May 18.
To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority.
Two multidisciplinary working groups formulated recommendations based on the GRADE approach.
Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy; combinations of exercise and manual therapy before medicine for NP; acupuncture for NP but not CR; traction for CR; and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR.
Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.
基于丹麦卫生当局的两项指南,总结关于近期发作(<12周)非特异性颈部疼痛(NP)和神经根型颈椎病(CR)的21种选定非手术干预措施的建议。
两个多学科工作组基于GRADE方法制定建议。
12项建议基于证据,9项基于共识。管理应包括有关预后、警示信号的信息,并建议保持活动。对于治疗,指南建议采用不同类型的有监督的运动和手法治疗;NP在用药前采用运动和手法治疗相结合的方法;NP可采用针灸治疗,但CR不适用;CR采用牵引治疗;NP和CR在仔细考虑后可使用口服非甾体抗炎药(口服或局部用药)和曲马多。
建议基于低质量证据或共识,但与北美的指南建议高度一致。工作组建议加强对NP和CR管理各方面的研究。