Management approach for chronic nonspecific neck pain

Chronic nonspecific neck pain has been poorly studied. Management should follow the same principles as for other types of noninflammatory chronic pain and be based on a multidimensional approach.

The principles of management for chronic nonspecific neck pain include:

• exercise—recommended for all patients
• developing a shared understanding with the patient about their condition, experience, and treatment goals
• reassurance about the nature of the pain—although some pain on activity is likely, this does not imply damage to the spine (ie ‘hurt does not mean harm’).

Some patients with chronic nonspecific neck pain require ongoing oral analgesia; see Pharmacological management of chronic nonspecific neck pain for more detail.

Multidisciplinary rehabilitation programs may be considered for patients with chronic nonspecific neck pain. These programs aim to simultaneously address all components (physical, psychological and social) of the patient’s pain experience.

Evidence does not support a role for surgery in chronic nonspecific neck pain.