Management approach for acute nonspecific neck pain
Most patients with acute nonspecific neck pain improve rapidly, and minimal intervention is required, beyond patient education and reassurance of favourable prognosis. Simple oral analgesia may be required; see Pharmacological management of acute nonspecific neck pain for dosage recommendations.
A shared understanding of the patient’s condition, experience, and treatment goals is a crucial component of management. Clinicians may find it helpful to:
- reassure patients that a serious cause for their pain is very unlikely
- advise patients to stay active—see Physical activity for acute nonspecific neck pain
- explain the outcome is generally favourable, although some patients may experience persistent symptoms for 6 to 12 months
- address any misconceptions about the nature of the pain, the source of the pain, as well as fear-avoidance behaviour (avoidance of activities based on fear of harm), which may contribute to deconditioning.
Printed or online information that reinforces these messages is useful to supplement advice provided by the clinician 1.
If there is persistent pain, not improving by 4 to 6 weeks, reassess the patient for any serious pathologies (including cervical myelopathy), cervical radiculopathy and other causes of referred neck pain. In patients with persistent pain, identify and manage any perpetuating psychosocial factors.