Chiropractic, Medication, and Self-care for Neck Pain

描述(申请人提供)：颈部疼痛非常常见， 相当大的社会经济后果。尽管会对公众健康造成影响， 对颈部疼痛状况的管理研究还不够充分。系统化 综述得出的结论是，尽管一些治疗方法看起来很有希望，但 有足够质量支持使用的随机临床试验太少了吗？ 一种疗法胜过另一种疗法。急性期/亚急性期颈部尤其如此 疼痛。虽然通常使用处方药治疗，但颈部疼痛 患者越来越多地通过互补和替代寻求缓解 药物疗法，比如脊椎推拿。鲜为人知的是， 然而，关于这些疗法的短期和长期相对疗效 以及它们与给病人自我护理的简单建议相比有什么不同。 这项研究的广泛、长期目标是确定有效的 对颈部疼痛患者的治疗，并增加我们对颈部的了解 疼痛状况。拟议的随机、观察者盲法临床试验是一项 有经验的脊椎按摩和医学研究人员的独特合作努力 并将重点关注急性/亚急性颈痛患者(持续12周)。 我们的调查小组最近完成的一项初步研究表明， 拟议的试验是可行的。这项研究的具体目标如下： 首要目标 为了确定脊椎按摩手法的相对疗效， 对于颈部疼痛的处方药和自我护理建议都是短期的 长期(6周后)和长期(52周后)，使用患者额定的颈部 以疼痛为主要结局指标。 次要目标 确定三者的短期和长期相对疗效 使用以下次要结果衡量标准的干预措施：患者评级 残疾、一般健康、改善、对护理的满意度、恐惧 避孕药和非处方药使用。 从以下方面确定三种干预措施的相对效果 对治疗视而不见的检查者测量的颈椎运动能力 分组作业。 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，那些 饱受这种痛苦和昂贵的疾病之苦。

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.