Are stretches & Exercises Helpful for Pain Relief? Research Studies Review & Pain Treatment

Stretches and exercises are utilized for a variety of reasons that include pain management, injury prevention, and increased range of motion and function.

Stretches & Exercises Research Studies

A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. In a 2015 systematic review by Gross, et. al, 27 trials looked at 2,485 analyzed and 3005 randomized participants who had done exercises for mechanical neck disorders.⁴² The systematic review intended to assess the effectiveness of exercise in improving pain, disability, function, patient satisfaction, and quality of life in neck pain patients. The participants were adults suffering from neck pain with or without cervicogenic headache or radiculopathy.⁴² The results of the study varied. For acute neck pain, no evidence was found; for chronic neck pain and chronic cervicogenic headache, moderate quality evidence was found; for acute radiculopathy, low quality evidence was found.⁴² They did find that using strengthening exercises for chronic neck pain, cervicogenic headache, and radiculopathy may be beneficial as well as using strength and endurance exercises for the cervico-scapulothoracic and shoulder may also be beneficial.⁴² The study concluded that due to the lack of high quality evidence, there is still uncertainty concerning the effectiveness of exercise for treating neck pain.⁴²

A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. In a 2014 systematic review of 32 studies, Da Silva Filho et al., assessed the effectiveness of stretching for posture correction.³⁴ Researchers found very little evidence supporting effectiveness in this particular treatment modality.³⁴

A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. In a 2004 systematic review of 6 studies by Thacker et al., researchers sought to determine if stretching has the capability to reduce the risk of a sports injury.³⁵ There was no evidence that supported either the continuation or discontinuation of stretching before or after exercise to reduce risk of injury.³⁵

A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. In a 2008 systematic review of 7 randomized controlled trials by Small et al., researchers found no decrease of overall exercise-related injuries by means of stretching.³⁶ However, researchers did find that musculotendinous injuries reduced as a result of static stretching.³⁶

A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. A systematic review carried out by Gordan and Bloxham examined 480 studies, but only 14 studies met the criteria on how physical activity or exercise interventions affected patients with non-specific chronic low back pain (NSCLBP), by specifically looking at aerobic exercise, muscular strength and stabilization exercises and/or flexibility training.³⁸ The researchers found that exercise programs that involved the previously mentioned methods are beneficial for NSCLBP, but did not help with acute low back pain, as exercise produced more swelling in the affected area.³⁸ On the other hand, ASTR treatment has been found to help with back pain according to several studies. 

系統綜述是一種文獻綜述，它收集並批判性地分析多項研究或論文。 A systematic review carried out by Saragiotto et. al, examined 2431 studies, but only included 29 trials that met the criteria on how motor control exercise (MCE) can aid in relief of patients with nonspecific low-back pain.⁴³ The study found: very low to moderate evidence that showed how MCE can clinically help chronic low-back pain; low quality evidence that MCE has a clinically important effect compared with exercise plus EPA; moderate to high quality evidence that showed how MCE provides similar outcomes to manual therapies and low to moderate quality evidence that it provides similar outcomes to other form of exercise.⁴³ Due to the evidence showing that MCE is not superior to the other methods of treatment, the choice of exercise for lower-back pain should be dependent on patient or therapist preferences.⁴³

Impingement syndrome is also known as Swimmer’s shoulder and is a common injury. Therapeutic exercise and orthopedic manual therapy are the most common treatments for impingement syndrome.⁴⁰ The systematic review by Desmeules et. al was conducted to review the effectiveness of therapeutic exercise and orthopedic manual therapy for the treatment of impingement syndrome.⁴¹ The studies were included if: they were a randomized controlled trial; they were related to impingement syndrome, rotator cuff tendinitis, or bursitis; one of the treatments included therapeutic exercise or manual therapy.⁴¹ Seven trials met this inclusion criteria and 4 of the 7 trials suggested some benefit of manual therapy or therapeutic exercise compared with other treatments such as acromioplasty, placebo, or no intervention.⁴¹ The study found that there is limited evidence that support the efficacy for treatment of impingement syndrome by using therapeutic exercise and manual therapy.⁴¹ Studies have shown that ASTR treatment can be effective in treating impingement syndrome and other shoulder injuries by relieving pain and increasing range of motion. ASTR stands for Advanced Soft Tissue Release, a manual therapy specialty developed by Dr. Joesph Jacobs, DPT. ASTR takes a holistic approach to treating the source of soft tissue restriction in a way that is virtually pain-free and highly effective.

Manual Therapy & Exercises Research Studies

Manual Therapy is often used with exercise to treat neck pain. In a systematic review by Miller et. al, they wanted to see if the combination of manual therapy and exercise was more effective than using either manual therapy or exercise alone. The participants were adults with acute to chronic neck pain with or without radiculopathy or cervicogenic headache. They selected 17 trials from 31 different publications with 1820 citation postings. Of the 31 different publications 17 studied acute neck pain, 5 studied whiplash associated disorders, 1 studied degenerative changes, 5 studied cervicogenic headache, and 3 studied neck disorders. The review suggests that when using manual therapy, there is greater short-term pain relief, rather than exercise alone, but there are no long-term differences across the multiple outcomes for acute/chronic neck pain.⁸ Moderate quality evidence supports the combination of manual therapy and exercise for pain reduction and improved quality of life over manual therapy alone for chronic neck pain.⁸ It also suggests greater short-term pain reduction when compared to traditional care for acute whiplash.⁸ It was found that a combination of manual therapy and exercise produce greater short-term pain reduction than exercise alone and longer-term changes across multiple outcomes when compared to manual therapy alone.⁸ Researchers found moderate, low, or no evidence supporting the idea that exercise is a beneficial mode of treatment in itself. 

On the other hand based on a recent study ASTR treatment can be effective in treating neck pain and improving the range of motion in the neck. ASTR stands for Advanced Soft Tissue Release, a manual therapy specialty developed by Dr. Joesph Jacobs, DPT. ASTR takes a holistic approach to treating the source of soft tissue restriction in a way that is virtually pain-free and highly effective.

有效的止痛治療

ASTR 通過解決肌肉失衡、疤痕組織、觸發點、筋膜限制、炎症、姿勢、身體力學（通常是疼痛的根源），以溫和、有效和自然的方式治療肌肉和關節疼痛。 ASTR 採用整體方法來解決疼痛的根本原因，而不僅僅是症狀。 ASTR 治療可以在家中進行肌肉和關節疼痛。

參考：

34. Filho JCANDS, Gurgel JL, Porto F. Effects of stretching exercises for posture correction: systematic review. Manual Therapy, Posturology & Rehabilitation Journal. 2014;12:200. doi:10.17784/mtprehabjournal.2014.12.200.

35. Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature. Medicine & Science in Sports & Exercise. 2004;36(3):371-378. doi:10.1249/01.mss.0000117134.83018.f7. 

36. Small K, Naughton LM, Matthews M. A Systematic Review into the Efficacy of Static Stretching as Part of a Warm-Up for the Prevention of Exercise-Related Injury. Research in Sports Medicine. 2008;16(3):213-231. doi:10.1080/15438620802310784.37. Borchers et al. A Systematic Review of the Effectiveness of Kinesis Taping for Musculoskeletal Injury 

38. Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare. 2016;4(2):22. doi:10.3390/healthcare4020022.

39. Ajimsha M, Al-Mudahka NR, Al-Madzhar J. Effectiveness of myofascial release: Systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies. 2015;19(1):102-112. doi:10.1016/j.jbmt.2014.06.001.

40. Desmeules et al. Impingement Syndrome: also called Swimmer’s Shoulder

41. Desmeules FCA, Côté CH, Frémont P. Therapeutic Exercise and Orthopedic Manual Therapy for Impingement Syndrome: A Systematic Review. Clinical Journal of Sport Medicine. 2003;13(3):176-182. doi:10.1097/00042752-200305000-00009.

42. Gross A, Kay TM, Paquin J-P, et al. Exercises for mechanical neck disorders. Cochrane Database of Systematic Reviews. 2015. doi:10.1002/14651858.cd004250.pub5. 

43. Saragiotto BT, Maher CG, Yamato TP, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Reviews. August 2016. doi:10.1002/14651858.cd012004.  

44. Cheatham SW、Kolber MJ、Cain M 等人。使用泡沫滾軸或滾軸按摩器進行自我肌筋膜釋放對關節運動範圍、肌肉恢復和性能的影響：系統評價。 國際運動物理治療雜誌。 2015 年 11 月；10(6):827-38。

45. Castro-Sánchez AMCAD, Matarán-Peñarrocha GA, Arroyo-Morales M, Saavedra-Hernández M, Fernández-Sola C, Moreno-Lorenzo C. 肌筋膜松解技術對纖維肌痛患者疼痛、身體功能和姿勢穩定性的影響: 隨機對照試驗。 臨床康復. 2011;25(9):800-813。 doi:10.1177/0269215511399476。