ECK DISORDERS REMAIN A common problem in modern, industrialized countries. Neck pain has been the most common chief complaint among working-aged women visiting their physicians. 1,2 In a Canadian study, 3 54% of the general population had experienced neck pain during the past 6 months, and approximately 5% were highly disabled by neck pain. The prevalence of chronic neck pain has been reported to be 7% in women and 5% in men in Finland. 4 Patients with chronic neck pain used health care services twice as much as the population on average. 2 Sick leave, therapy, and specialist care form the major part of the costs incurred by neck pain, whereas investigations at the primary health care level play a minor role. 5 The origin and exact pathophysiologic mechanisms of chronic neck pain often remain obscure because trauma or severe degenerative conditions at working age are found only in Author Affiliations are listed at the end of this article.

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Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain. The difference in effectiveness between the 2 treatments was minor. Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.

BackgroundRotator cuff repair incidence rates have reportedly increased in the United States and England. Here we analyzed nationwide data relating to rotator cuff repairs recorded in the Finnish National Hospital Discharge Register (NHDR).MethodsThe NHDR was reviewed to identify adult patients who underwent rotator cuff repair between 1998 and 2011. Incidence rates per 105 person-years were calculated using the annual adult population size.ResultsDuring the 14-year time period, 50,646 rotator cuff repairs were performed on subjects aged 18 years or older. The incidence of rotator cuff repair showed an almost linear increase of 204 %, from 44 per 105 person-years in 1998 to 131 per 105 person-years in 2011. The most common concomitant procedure was acromioplasty, which was performed in approximately 40 % of rotator cuff repairs in 2011. Other common concomitant procedures included tenodesis (7 %) and tenotomy (6 %) of the long head of the biceps tendon, and resection of the acromioclavicular joint (3 %).ConclusionsThis nationwide analysis revealed a remarkable increase in the incidence of rotator cuff repair from 1998 to 2011 in Finland. This progress can be questioned, since there are not convincing data of the superiority of the operative treatment over non-operative management in all rotator cuff tears.

Exercises are commonly recommended for chronic neck pain, but evidence-based guidelines do not explain what types of exercise. The aim of this randomized study was to evaluate the rate of change in neck strength following high- and low-intensity neck muscle training and their effects on pain and disability. One hundred eighty women with chronic neck pain were randomized into a high-intensity strength training group (STG), local muscle endurance training group (ETG), or control group (CG). The neck training consisted of isometric exercises in the STG and dynamic exercises in the ETG. Both groups performed dynamic exercises for the upper extremities. Strength tests, neck pain, and disability indices were evaluated at the baseline, at the follow-ups after 2 and 6 months in the training groups, and after 12 months in all groups. In both groups the greatest gains in neck strength, as well as decrease in neck pain and disability, were achieved during the first 2 months. However, the improvements continued up to 12 months. The STG achieved the greatest strength gains at all follow-ups. The CG showed only minor changes, and significant differences were found in favor of the training groups in all measures. The change in neck pain and disability indices correlated with the isometric neck strength (r = -0.22 [-0.36 to - 0.08] to -0.36 [-0.49 to -0.23]). Neck and shoulder muscle training was shown to be an effective therapy for chronic neck pain, resulting in early improvement in both the strength tests and subjective measures. The results can be maintained and even improved with long-term training.