Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Language: 
English
Short Title: 
Are psychological interventions effective for the management of neck pain and whiplash-associated disorders?
Abstract: 

BACKGROUND CONTEXT: In 2008, the lack of published evidence prevented the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force [NPTF]) from commenting on the effectiveness of psychological interventions for the management of neck pain. PURPOSE: This study aimed to update findings of the NPTF and evaluate the effectiveness of psychological interventions for the management of neck pain and associated disorders (NAD) or whiplash-associated disorders (WAD). STUDY DESIGN/SETTING: This study used systematic review and best-evidence synthesis. SAMPLE: Randomized controlled trials, cohort studies, and case-control studies comparing psychological interventions to other non-invasive interventions or no intervention were the samples used in this study. OUTCOME MEASURES: The outcome measures are (1) self-rated recovery; (2) functional recovery; (3) clinical outcomes; (4) administrative outcomes; and (5) adverse effects. METHODS: We searched six databases from 1990 to 2015. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers used the Scottish Intercollegiate Guidelines Network criteria to critically appraise eligible studies. Studies with a low risk of bias were synthesized following best evidence synthesis principles. This study was funded by the Ontario Ministry of Finance. RESULTS: We screened 1,919 articles, 19 were eligible for critical appraisal and 10 were judged to have low risk of bias. We found no clear evidence supporting relaxation training or cognitive behavioral therapy (CBT) for persistent grades I-III NAD for reducing pain intensity or disability. Similarly, we did not find evidence to support the effectiveness of biofeedback or relaxation training for persistent grade II WAD, and there is conflicting evidence for the use of CBT in this population. However, adding a progressive goal attainment program to functional restoration physiotherapy may benefit patients with persistent grades I-III WAD. Furthermore, Jyoti meditation may help reduce neck pain intensity and bothersomeness in patients with persistent NAD. CONCLUSIONS: We did not find evidence for or against the use of psychological interventions in patients with recent onset NAD or WAD. We found evidence that a progressive goal attainment program may be helpful for the management of persistent WAD and that Jyoti meditation may benefit patients with persistent NAD. The limited evidence of effectiveness for psychological interventions may be due to several factors, such as interventions that are ineffective, poorly conceptualized, or poorly implemented. Further methodologically rigorous research is needed.

Author(s): 
Shearer, Heather M.
Carroll, Linda J.
Wong, Jessica J.
Côté, Pierre
Varatharajan, Sharanya
Southerst, Danielle
Sutton, Deborah A.
Randhawa, Kristi A.
Yu, Hainan
Mior, Silvano A.
van der Velde, Gabrielle M.
Nordin, Margareta C.
Stupar, Maja
Taylor-Vaisey, Anne L.
Item Type: 
Journal Article
Publication Title: 
The Spine Journal: Official Journal of the North American Spine Society
Journal Abbreviation: 
Spine J
Publication Date: 
2016-12
Publication Year: 
2016
Pages: 
1566-1581
Volume: 
16
Issue: 
12
ISSN: 
1878-1632
DOI: 
10.1016/j.spinee.2015.08.011
Library Catalog: 
PubMed
Extra: 
PMID: 26279388

Turabian/Chicago Citation

Heather M. Shearer, Linda J. Carroll, Jessica J. Wong, Pierre Côté, Sharanya Varatharajan, Danielle Southerst, Deborah A. Sutton, Kristi A. Randhawa, Hainan Yu, Silvano A. Mior, Gabrielle M. van der Velde, Margareta C. Nordin, Maja Stupar and Anne L. Taylor-Vaisey. 2016-12. "Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration." The Spine Journal: Official Journal of the North American Spine Society 16: 12: 1566-1581. 10.1016/j.spinee.2015.08.011.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1016/j.spinee.2015.08.011 | issn = 1878-1632 | volume = 16 | pages = 1566-1581 | last = Shearer | first = Heather M. | coauthors = Carroll, Linda J., Wong, Jessica J., Côté, Pierre, Varatharajan, Sharanya, Southerst, Danielle, Sutton, Deborah A., Randhawa, Kristi A., Yu, Hainan, Mior, Silvano A., van der Velde, Gabrielle M., Nordin, Margareta C., Stupar, Maja, Taylor-Vaisey, Anne L. | title = Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration | journal = The Spine Journal: Official Journal of the North American Spine Society | date = 2016-12 | pmid = | pmc = }} </ref>