Neck pain is a common and costly medical ailment. Few studies of really effective medical treatments exist compared with those, say, for low back pain.

Many drugs used in clinical practice have been tried. Among those are nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, neuroleptic agents, and opioid analgesics.

While uncontrolled studies show benefit, controlled studies are lacking. So what has been shown to work so far? According to a recent study, there are only two medicines that have been proven to be effective. The first is intravenous methylprednisolone for acute whiplash used within eight hours for whiplash and the second is intramuscular lidocaine for chronic mechanical neck disorders. (Peloso PM, Gross AR, Haines TA, et al. Medicinal and injection therapies for mechanical neck disorders: a Cochrane systemic Review. J Rheum 2006; 33:957-967).

What is disheartening is that the usual treatments such as anti-inflammatory drugs and acetaminophen have been largely ineffective- at least according to this one large study.

Even epidural injections were classified as showing "limited evidence of benefit."

A number of interventions in this large study were ineffective. These include: