Summarizing the effects of different exercise types in chronic neck pain - a systematic review and meta-analysis of systematic reviews.

For people with chronic neck pain (lasting 12 weeks or more), it's unclear whether one type of exercise works better than another. This paper is a review of reviews: the authors searched multiple databases and pulled together 25 systematic reviews and meta-analyses covering 17,321 participants in total (without accounting for overlap between reviews), looking at motor control exercise, Pilates, resistance training, traditional Chinese exercise, and yoga. They found low to high certainty evidence that all five exercise types improved pain in the short term compared to non-exercise controls, and all except resistance training improved disability. When exercise types were compared against each other, results were mixed and evidence was only low to moderate certainty, both short-term and longer-term, with no long-term data available for yoga.

A major limitation was that the quality of included reviews varied widely, from critically low to moderate/high, which limits confidence in some conclusions.

If you have chronic neck pain, meaning it's lasted 12 weeks or longer, you may wonder which type of exercise is likely to help most. This study pulled together 25 existing reviews, covering over 17,000 participants total, looking at five exercise approaches: motor control exercise (which focuses on retraining muscle coordination), Pilates, resistance training, traditional Chinese exercise (like tai chi), and yoga. The researchers found that compared to not exercising, all five types showed short-term improvements in pain, and all except resistance training also improved disability, though the certainty of this evidence ranged from low to high depending on the exercise type.

When different exercise types were compared directly against each other, the results were inconsistent, and the evidence was less certain, with no long-term data available for yoga at all. Importantly, the quality of the underlying reviews varied a lot, from critically low to moderate/high quality, which affects how much confidence we can place in these findings. The authors concluded that no single exercise type stood out as clearly better than the others for chronic neck pain.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This umbrella review pooled 25 systematic reviews and meta-analyses (17,321 participants total, overlap across reviews not adjusted for) examining motor control exercise, Pilates, resistance training, traditional Chinese exercise, and yoga for chronic neck pain (≥12 weeks duration). Review quality, assessed via AMSTAR-2, ranged from critically low to moderate/high, with 13 of 25 reviews rated critically low to low quality, a substantial constraint on interpretation. Using GRADE, the authors found low to high certainty evidence that all five exercise types produced short-term pain improvements versus non-exercise controls, and all except resistance training improved disability.

Comparisons between exercise types produced conflicting results at both short-term and intermediate/long-term follow-up, with only low to moderate certainty evidence, and no long-term data existed for yoga. The narrative synthesis, supplemented by meta-analysis where feasible, did not identify one exercise type as superior to others. Given the heterogeneous quality of underlying reviews and inconsistent head-to-head comparisons, these findings should be read as indicating a general short-term benefit of exercise over no exercise, rather than evidence favoring any specific modality.