Neck disorders affect 23.1% of adults at any one time and up to 30% of men and 50% of women in the course of a lifetime (Valkenburg et al. 1980, Aker et al. 1996, Borghouts et al. 1998). Prevalence is generally higher in high-income, urban countries compared with low- and middle income, rural countries and peaks in the middle age group. Precise diagnosis is problematic because signs and symptoms are frequently nonspecific and have poor Reproducibility (Bogduk and Lord 1998).
In 2020 Sutariya and Shukla found improvements in Numerical Pain Rating Scale [NPRS] Score, Neck Disability Index [NDI] Score and Pain Pressure Threshold [PPT] Score post shortwave treatment. They said shortwave diathermy worked in several ways on mechanical neck pain:
- Altered the cell membrane permeability which opens the sodium channel and congest the area & thereby inhibiting sodium potassium pump, which, in turn, slows rate of depolarization, thus increasing the pain threshold.
- Increased blood flow in the muscles, capillary filtration, capillary pressure and increased oxygen perfusion thus producing relief in pain caused by ischemia and hypoxia.
- Primary pain relief immediately after application of shortwave diathermy is often thought to be associated with decreased muscle spasm, reduction of adhesion and contracture and increased blood flow. This improvement in pain may have led to improvement in function and PPT in patients with mechanical neck pain.
In a 2021 article El Mohammad et al. used a pulsed shortwave device that is applied 24hrs a day for 4 weeks to patients with cervical spine osteoarthritis. They compared the shortwave device to traditional anti inflammatory medications. They found reductions from baseline in VAS rest and VAS activity were significantly greater in the PSWT arm than NSAID arm. And also found the PSWT group used 50% less rescue pain medication.
Recommendation:
- Single Head =
- Pulsed or continuous
- Stay between 4w and heating effect
- Frequency = daily down to 1x per week
- 20 mins up to 24hrs (personal devices only)
- For 3-6 weeks
- Combine with exercises for best results
Shakoor et al. (2001) found that there was significant improvement after giving shortwave diathermy to patients with neck pain. 56% of patients had a significant improvement, however, 5 patients in the shortwave group reported feeling worse in the initial stages of the trial. At the end of the study these 5 patients were not worse than when they had started. This may be a reflection of 2 elements of the study. They wanted the shortwave to heat the patients. In acute problems this may simply increase the inflammation and hence pain. In chronic patients heat reduces muscle spasm and this in turn can decrease the stability of the neck leading to increased pain (just as muscle relaxant medication can give the same effect).