Physical medicine and rehabilitation clinics of North America
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A variety of drug types are available for the treatment of pain. Significant relief of acute neck pain is usually achievable. Treatment of chronic neck pain requires a more comprehensive rehabilitation approach combined with judicious use of medications. Research on the development of analgesics that affect other neurotransmitter systems and that have fewer side effects is currently underway.
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The literature on physical and functional measurements for the cervical spine is more limited than for the lumbar spine. Most of the studies so far have dealt with the methods for range-of-motion measurements in the cervical spine. These studies indicate that newer computer-guided, three-dimensional measurements systems may provide more precise and reliable data than inclinometer-based techniques and visual estimation methods. ⋯ In addition to physical measurements, several tests have been developed to measure pain level, psychologic factors, disability from neck pain, and generic health, which can assist the clinician in choosing the most appropriate treatment for patients with neck pain. Furthermore, functional measurement systems, such as FCEs, have been developed to describe the functional limitations that a patient may have as a result of a spinal injury. Except for the range-of-motion measurement methods, much more research is required to determine which measurement systems provide the optimal balance between reliability and validity and pragmatic considerations such as time and expense.