Effects of multimodal interventions on patients with neck pain: a systematic review and meta-analysis

To evaluate the impact of multimodal therapy on patients with neck pain. A comprehensive search was conducted in PubMed, Cochrane Library, Web of Science, and Embase databases from their inception until April 2024. Randomized controlled trials (RCTs) involving multimodal therapy for neck pain were included. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 software. A total of 10 studies were included. The meta-analysis results showed that multimodal therapy significantly reduced the Visual Analogue Scale (VAS) scores for neck pain [Standardized Mean Difference (SMD) = -2.96, 95% Confidence Interval (CI): -4.21 to -1.71, P < 0.001] and the Neck Disability Index (NDI) scores [Mean Difference (MD) = -6.15, 95% CI: -10.25 to -2.04, P < 0.01], decreased kinesiophobia [MD = -18.48, 95% CI: -29.22 to -2.74, P < 0.001], and increased the pressure pain threshold (PPT) [left trapezius: MD = 0.48, 95% CI: 0.20 to 0.77, P < 0.01; right trapezius: MD = 0.50, 95% CI: 0.22 to 0.79, P < 0.01]. Subgroup analysis revealed that when the intervention duration was greater than 4 weeks, multimodal therapy significantly improved neck function [MD = -5.97, 95% CI: -11.52 to -0.42, P = 0.04]. Multimodal therapy can effectively reduce pain severity, improve kinesiophobia and pain thresholds in patients with neck pain, and significantly improve neck function when the intervention duration exceeds 4 weeks. Future studies with larger sample sizes and higher quality are needed for further exploration.