CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Neck pain - non-specific - Management
Basis for recommendation
- These recommendations are based on expert advice in a primary care textbook [Williams and Hoving, 2004].
- Some evidence from prospective cohort and cross-sectional studies suggests that psychosocial factors and a high physical workload are important risk factors for neck pain. A Swedish survey found that 30% of respondents with chronic neck pain reported previous injury to the neck [Guez et al, 2003].
- In the absence of 'red flags', plain X-rays of the cervical spine are unlikely to help and may lead to false-positive findings [Williams and Hoving, 2004].
- Radiographs of the cervical spine may suggest muscle spasm (loss of normal cervical lordosis).
- Features of degenerative disease are also common in asymptomatic people older than 30 years of age and correlate poorly with clinical symptoms. The boundary between normal ageing and disease is very difficult to define [Binder, 2007b].
© NHS Institute for Innovation and Improvement