Treatment – Book Companion App (2025)

The treatment for neck pain depends on the different profiles that the patient was categorized in after the analysis:

Profile A

Goal: Educate and facilitate active coping

• Explain the normal course of neck pain: Normal course of neck pain is favorable and neck pain is not damaging or reflects the level of tissue damage
• Advise and motivate the patient to gradually increase his activity, participation and exercise level and to return to work
• If the neck pain is work-related: Adjust the work space and explain how different work-related prognostic factors can negatively influence the recovery
• If your patient is on sick leave you can suggest your patient to contact a physiotherapist that is specialized in work-related issues

N.B. Maximal number of treatment sessions should be 3!

Profile B

Goal: Influence prognostic factors

• Education and advice like in profile A
• Provide exercise therapy (in line with the patient‘s needs, limitations and goals) with cervical and/or thoracic mobilization/manipulation
• If the above-mentioned treatment is not successful, the therapist can consider following optional treatment options: cervical pillow, cognitive behavioral therapy, kinesiotaping in case of trauma-related neck pain to decrease pain on short-term, massages in combination with other therapies to decrease pain on short-term, heat and cryotherapy also in combination with other forms of therapy
• The guideline discourages the use of dry needling, electrotherapy, ultrasound or laser therapy
• If the neck pain is work-related: Like profile A + motivate your patient to contact a physiotherapist that is specialized in work-related issues or the company’s general practitioner to evaluate treatment options
• If your patient is on sick leave or is less productive not longer than 4 weeks: Ask the patient about arrangements being made with the company’s physician or ask him to get in touch with a physiotherapist that is specialized in work-related issues to coordinate further management
• Evaluate the content of your treatment, commitment to treatment and the results with an NP(R)S and PSC scale

N.B. Terminate the treatment if goals have been reached or if no improvement is achieved after 6 weeks of treatment.
If the treatment has not had any effect on pain or activity level, contact the general practitioner to evaluate further treatment options.

Profile C

Goal: Influence psychosocial prognostic factors

• Approach like in Profile B
• Focus less on your patient’s pain as this can lead to increased attention on your patient’s pain and pain behavior
• Explain to your patient how psychosocial prognostic factors like fear, depression, restlessness, kinesiophobia and catastrophizing can have a negative influence on recovery
• In case of kinesiophobia you should explain that activity is promoting recovery and motivate them to move more
• Continually discuss the influence of psychosocial factors that lead to a delayed recovery in order to evaluate if those factors have changed or if their influence on the neck pain has become less
• If psychosocial factors are the main reason that your patient is not recovering, you should advise your patient to discuss further treatment options with their general practitioner, a psychologist or a psychosomatic physiotherapist
• During the exercise part of the treatment, you should stress behavioral principles and graded exposure to movement
• Other treatment options like mentioned in profile B can be taken into consideration as well

N.B. Terminate the treatment if goals have been reached or if no improvement is achieved after 6 weeks of treatment.
If the treatment has not had any effect on pain or activity level, contact the general practitioner to evaluate further treatment options.

Profile D

Goal: Management according to a clear time path

• Approach like in profile B with the following differences:
• Explain the diagnosis to your patient and reassure them that neurological signs in the arm often diminish on their own
• Promote an active physical lifestyle and an active coping style but at the same time your patient should avoid movements which worsen the radiating pain or other complaints in the arm
• Exercise therapy with mobilizations and manipulations combined with nerve mobilization
• Optional: Semi-rigid neck brace to reduce pain on short-term (effect should be evaluated after 2 weeks to prevent dependence, except in trauma-related cases)
• Traction can be considered if the above-mentioned exercise approaches do not have sufficient effects

N.B. Refer the patient back to their general practitioner if treatment is ineffective (within the agree time frame or at 6 weeks maximum) or if complaints worsen.

6 weeks of treatment is considered the maximum time of treatment in all profiles, due to the fact that the chance of improvement after this time period severely decreases.