Chiropractic, Medication, and Self-care for Neck Pain

描述（由申请人提供）：颈部疼痛非常常见， 相当大的社会经济后果。尽管对公众健康有影响， 对颈痛病症的管理研究不足。系统 综述得出的结论是，虽然一些治疗方法似乎有希望， 缺乏足够质量的随机临床试验来支持使用 一种疗法胜过另一种疗法对于急性/亚急性颈部，尤其如此 痛苦虽然通常用处方药治疗，但颈部疼痛 患者越来越多地通过补充和替代疗法寻求缓解。 药物治疗，如脊椎按摩。我们所知甚少， 然而，关于这些疗法的短期和长期相对疗效， 以及它们与给病人简单的自我护理建议的比较。 这项研究的广泛和长期目标是确定有效的 颈部疼痛患者的治疗，并增加我们对颈部疼痛的了解。 疼痛状况。拟议的随机、双盲临床试验是一项 由经验丰富的脊椎按摩疗法和医学研究人员共同努力， 并将重点关注急性/亚急性颈部疼痛患者（持续时间<12周）。 我们的调查小组最近完成的一项试点研究表明， 试验是可行的。这项研究的具体目标如下： 主要目的 为了确定脊椎按摩疗法的相对疗效， 处方药，和自我保健的建议，颈部疼痛，在短期内 长期（6周后）和长期（52周后），使用患者评定的颈部 疼痛作为主要的结果指标。 次要目的 确定三种药物的短期和长期相对疗效 使用以下次要结局指标进行干预： 残疾，一般健康，改善，护理满意度，恐惧 回避和非处方药的使用。 确定三种干预措施在以下方面的相对疗效： 由对治疗不知情的检查者测量颈椎运动性能 分组分配。 这项研究将有助于缩小科学文献中的巨大差距 关于两种常用治疗方法的相对疗效， 急性/亚急性颈部疼痛。它还将提供临床有用的信息 对于卫生保健从业者、政策制定者，最重要的是， 遭受这种痛苦和昂贵的条件。

DESCRIPTION (provided by applicant): Neck pain is very common, with considerable socioeconomic consequences. Despite the public health impact, management of neck pain conditions has been inadequately researched. Systematic reviews have concluded that, although some therapies appear promising, there are too few randomized clinical trials of sufficient quality to support the use of one therapy over another. This is especially true for acute/subacute neck pain. Although commonly treated with prescription medications, neck pain sufferers are increasingly seeking relief through complementary and alternative medicine therapies, like chiropractic spinal manipulation. Little is known, however, about the short- and long-term relative efficacy of these therapies and how they compare to giving patients simple advice on self-care. The broad, long-term objective of this research is to identify effective therapies for neck pain sufferers and to increase our understanding of neck pain conditions. The proposed randomized, observer-blinded clinical trial is a unique collaborative effort by experienced chiropractic and medical researchers and will focus on patients with acute/subacute neck pain (<12 weeks duration). A pilot study recently completed by our investigative team shows that this proposed trial is feasible. The study has the following specific aims: Primary Aim To determine the relative efficacy of chiropractic spinal manipulation, prescription medication, and self-care advice for neck pain in both the short term (after 6 weeks) and long term (after 52 weeks), using patient-rated neck pain as the main outcome measure. Secondary Aims To determine the short- and long-term relative efficacy of the three interventions using the following secondary outcome measures: patient-rated disability, general health, improvement, satisfaction with care, fear avoidance, and over-the-counter medication use. To determine the relative efficacy of the three interventions in terms of cervical spine motion performance measured by examiners blinded to treatment group assignment. This research will help narrow the large gap in the scientific literature regarding the relative efficacy of two commonly used treatments for acute/sub-acute neck pain. It will also provide clinically useful information for health care practitioners, policy makers and, most importantly, those who suffer from this painful and costly condition.