Citizens With Disabilities - Ontario


A Pain In The Neck: Exercise, Acupuncture, Massage May Provide Relief

Published Monday March 10th, 2008

Having endured two bouts of whiplash as a result of separate car accidents, Marc White knows all too well about the persistent problems caused by neck pain.

White, director of the Canadian Institute for the Relief of Pain and Disability, recalls that in one of the accidents, his car was struck by a bus for people with disabilities - a fact he considers more than a little ironic.

"I think the driver needed more business," he says with a laugh.

But White says chronic neck pain is no joke and a recently released seven-year study on the issue has underscored the breadth of the problem and the many challenges involved in dealing with people suffering its effects.

"Neck pain is very prevalent in society," White says of the international task force study on neck pain and associated disorders.

"Up to 70 per cent of the population will experience an episode of neck pain."

The task force, which included experts from Canada, synthesized all of the available research on neck pain and produced a comprehensive review of causes, effects and treatments.

Dr. Linda Carroll, an assistant professor in the School of Public Health at the University of Alberta and one of the scientific leaders of the study, says there is no magic bullet for dealing with neck pain.

She says exercise, mobilization and manipulation of the neck, acupuncture, massage, low-level laser therapy and analgesics all can provide some measure of relief, but the effects tend to be modest and short-lived.

"People may find they have to try a variety of therapies or a combination of therapies," she said in an interview.

"We're suggesting that patient preference be an important factor in deciding treatment."

Carroll says the study found that ultrasound treatment and neck collars, both hard and soft, should not be used.

"They are being used less and less," Carroll says of the collars, which once were a popular method of treatment.

"Necks are designed to be moved."

Carroll says she was surprised by how common neck pain is in today's society. She says it affects people of all ages, including children and teens.

Its causes range from accidents and sports injuries to stress, poor posture and lack of exercise.

"Most people can carry on with their usual activities, but for about one or two people in 20, the neck pain creates serious limitations in their activities," she says.

White, who is also a professor at the University of British Columbia and a research fellow at Harvard, had a host of possible remedies at his fingertips when he was suffering from whiplash.

"I had everything possible done," he says.

"Eventually I found that a hot bath took less time."

White says the only lasting relief he got was from a procedure called dry needling, or intramuscular stimulation, in which acupuncture needles were inserted to unlock muscle spasms.

"I actually had fairly permanent relief following the dry needling," he says.

"It goes to the fourth and fifth layer of muscle groups, to where you may have small muscle spasms, and it releases those muscle spindles. It worked well for me, but it may not work for everybody."

White says the task force study found that serious neck pain could be reduced by 35 per cent if people had cars with better head restraint systems and used them appropriately.

"That's a startling figure," he says.

"From a public health perspective, the best way to deal with serious neck pain, at least for motor vehicle collisions, is improved regulations and education."

He says that about 60 per cent of the cars on the road today do not have good head restraint systems.

White says the U.S. government has legislated that all vehicles must have better head restraint geometry by 2009, but he says it has been 40 years since Canada changed its regulations.

Whiplash is an injury to the neck that usually occurs because of sudden extension and flexion, often during an auto accident. Most whiplash victims recover in a few months, but many report recurring pain a year or more later.

Reproduced from

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