Neck pain in South Africa: An overview of the prevalence, assessment and management for the contemporary clinician

Abstract

BackgroundNeck pain is a prevalent condition and is associated with high levels of disability and pain. The long-term prognosis can be poor, and therefore effective management in the acute stage is important.ObjectivesTo provide an overview of the prevalence of neck pain and physiotherapy management and to provide evidence-informed recommendations for clinical practice within a South African context.MethodThe literature was reviewed considering prevalence, risk factors and examination. Management recommendations were derived from the highest levels of evidence of clinical practice guidelines, systematic reviews and randomised clinical trials.ResultsNeck pain is classified into four grades, and three trajectories of recovery have been identified. Although the incidence of neck pain globally is high, in the South African context the majority of the population have limited access to physiotherapy management. Sound clinical reasoning is important in the assessment and decision-making process for management. Exercise, and mobilisation or manipulation are effective treatment options in the management of most types of neck pain. Other physical modalities such as needling, transcutaneous electrical nerve stimulation, laser and intermittent traction may be used as an adjunct to management.ConclusionThe burden of neck pain globally is high; however, there is a lack of information on current practice, prevalence and burden of neck pain in the South African context. Sound evidence-informed clinical reasoning to inform a working diagnosis and to enable patient-centred management is important.Clinical implicationsA thorough assessment is essential to gather information to formulate hypotheses regarding diagnosis and prognosis for neck pain. Exercise, and mobilisation or manipulation are effective management options.

Factors Related to Nurses’ Knowledge and Attitudes Toward Pain in Hospitals in Low-Income Areas

“…Data from a systematic review that was published in 2014 concluded that 31.8% of cancer patients with pain were undertreated (Greco et al, 2014). More than half of the low-and middle-income population had limited access to management of neck pain (Basson et al, 2019). It was shown that patients enduring pain from sickle cell disease were more burdened and affected in Africa compared with the United State owing to the former's lack of access to analgesics, (Zempsky et al, 2014).…”

The Effect of Neural Mobilization on Muscle Strength, Reaction Time And Pain Threshold

“…One of the limitations of our study is that we investigated the effects of neural mobilization after only one session. Unlike the present study design, Kumar et al investigated the effects of neural gliding and massage on vibration, heat, and cold perception thresholds in patients with painful diabetic peripheral neuropathy While they found a statistically significant difference between pre-and immediately post-and pre-and 15 minutes postneural gliding and massage, they did not find any difference between immediately post-and 15 minutes post-treatment (Kumar et al, 2010) Although the literature includes more single-session efficacy studies after neural mobilization, there have also been follow-up studies conducted in different time periods (Pereira et al, 2021;Ballestero-Perez et al, 2017;Basson et al, 2019;Plaza-Manzano et al, 2020). One of these studies, published by Oskay et al, examined seven individuals with cubital tunnel syndrome.…”

Efficacy and central mechanism of acupuncture treatment in patients with neck pain: study protocol for a randomized controlled trial

“…It is estimated that more than 30% of the population suffer from NP each year [ 2 ], and its lifetime prevalence in adults ranges from 14.2 to 71% [ 3 ]. Due to the increasing prevalence of NP, the health care costs of NP have rapidly increased [ 4 – 6 ].…”