Steer Clear of Neck Braces

[originally published in KCN, December 2009]

Cervical Soft CollarEver so often I will spot someone wearing a brace around their neck. To be clear, I’m not talking about the rigid neck braces that EMT’s and paramedics employ to stabilize a suspected neck injury when they arrive on an accident scene. I’m talking about the soft, usually white, neck-supporting collars that are worn by people who are suffering from neck pain. These devices are often prescribed by well-meaning doctors, or are purchased by patients themselves at local pharmacies as a form of self-care for neckache. And while they look official, the irony is that they don’t do a bit of good. In fact, according to most research, they actually do more harm than good!

Thumb-Spine-JournalIn 1998 the medical journal Spine ran a Norwegian study that evaluated the first 14 days of treatment for 201 patients with whiplash that were involved in motor vehicle accidents.  Half of the patients were given soft cervical collars to wear.  The other half were instructed to “act as usual” and essentially not given any treatment whatsoever.  After six months, the study found that those in the “Act-As-Usual” group had better outcomes! Granted, many in this group were not healed — with 10 percent continuing to report severe symptoms.  But it was found that those in the group that wore the cervical collars were significantly worse — especially when it came to stiffness and pain localization.

Journal Bone and Joint SurgeryA 1974 study in the Journal of Bone and Joint Surgery found that whiplash patients wearing soft cervical collars for 12 weeks post injury had a greater incidence of continued symptoms and arthritic changes on x-ray than did their non-collar wearing counterparts. And this was discovered on a follow-up examination conducted five or more years later.

European Spine JournalAnother study found in the 2002 edition of the European Spine Journal looked back on 154 patient files from 1983. All of these patients had presented with neck pain to hospitals in Gothenburg, Sweden following involvement in motor vehicle accidents. Each one of them was initially treated with analgesics and — you guessed it — a soft cervical collar. Seventeen years later, these patients were reevaluated. Not counting those who had been reinjured or had developed other unrelated complications, a whopping 55 percent still had residual disorders (eg. headaches, neck pain, radiating arm pain) that was traced back to the original accident.

The research is pretty clear that neck braces are “out.” Some argue that it can give symptomatic relief. But, unfortunately, this viewpoint does not adequately evaluate the long term ramifications.

The research is also pretty clear that movement is “in.” Early movement intervention in the form of stretches and exercises found patients faring far better than those that wore neck braces.

Proper and complete healing of soft tissue following a whiplash or other neck injury is dependent on motion. While some of this motion can be obtained through active and passive stretching, Doctors of Chiropractic are able to provide patients with additional movement unobtainable otherwise. It is this extra range of movement that allows soft tissues to experience a much greater and complete level of healing.

InjuryPerhaps this is why a 1996 study in the medical journal Injury found improvement in 93 percent of whiplash patients starting a regimen of chiropractic care after 15 months of unsuccessful traditional medical care (which included rest, soft cervical collars, and physical therapy).

So if you are suffering from neck pain and have a neck brace, consider changing your wardrobe ensemble, find a way to repurpose it, and get moving — to your chiropractor’s office.

____________
Source used for this article:
Borchgrevink, Kaasa, McDonagh, Stiles, Haraldseth, and Lereim. Acute treatment of whiplash neck sprain injuries. Spine. 1998;23:25.
Bunketorp, Nordholm, and Carlsson. A descriptive analysis of disorders in patients 17 years following motor vehicle accidents. European Spine Journal. 2002;11:227.
Muzin, Issac, Walker, Abd, and Baima.  When should a cervical collar be used to treat neck pain?  Curr Rev Musculoskelet Med. 2008; 1:114–119.
Norris and Watt. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg. 1983; 65B:608.

Rosenfeld , Gunnarsson, Borenstein, and Cassidy. Early Intervention in Whiplash-AssociatedDisorders – A Comparison of Two Treatment Protocols. Spine. 2000;25:1782.

Rosenfeld , Seferiadis, Carlsson, and Gunnarsson. Active intervention in patients with whiplash associated disorders improves long-term prognosis. Spine. 2003;28:2491.

Schnabel, Ferrari, Vassiliou, and Kaluza . Randomised, controlled outcome study of active mobilisation compared with collar therapy for whiplash injury. Emerg Med J. 2004;21:306.
Woodward , Cook, Gargan, and  Bannister. Chiropractic treatment of chronic whiplash injuries. Injury. 1996;27:643.
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