National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

Per Kjaer, Alice Kongsted, Jan Hartvigsen, Alexander Isenberg-Jørgensen, Berit Schiøttz-Christensen, Bolette Søborg, Charlotte Krog, Christian Martin Møller, Christine Marie Bækø Halling, Henrik Hein Lauridsen, Inge Ris Hansen, Jesper Nørregaard, Karsten Juhl Jørgensen, Lars Valentin Hansen, Marie Jakobsen, Martin Bach Jensen, Martin Melbye, Peter Duel, Steffan W. Christensen, Tina Myung Povlsen

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.