Effectiveness of a general neck exercise program, of acupuncture or of repetitive low-energy shockwave therapy for chronic neck disorders

INTERVENTION: General neck exercise program: Posture correction techniques and active range of movement exercises are delivered. The active range of movement exercises prescribed are at the therapist's discretion, but can include flexion, extension, side flexion, and rotation. Posture correction will be taught in the context of functional and work activities. Total duration of treatment: 4 weeks Total duration of follow‐up: 15 months from baseline Acupuncture: We use single‐use, sterile, silver‐handle, prepacked needles without guide tubes. We base point selection on individualised western acupuncture techniques by using a list of points previously reported as being effective in neck pain. The specific points for each individual are defined at each treatment session, depending on the patient's pain distribution and palpation of the neck and thorax to determine ah‐shi points, or local tender points, for acupuncture. At least 1 distal point is used. Total duration of treatment: 4 weeks Total duration of follow‐up: 15 months from baseline Shockwave therapy: Painful muscles are identified and tender points are treated with low‐energy shockwave therapy (EFD = 0.1 mJ/mm^2, 2000 shocks per muscle, 3 sessions 1 ‐ 2 weeks apart). Total duration of treatment: 4 weeks Total duration of follow‐up: 15 months from baseline CONDITION: Neck disorders ; Musculoskeletal Diseases ; Dorsalgia PRIMARY OUTCOME: 1. Neck pain on a 100 mm visual analogue scale; 2. Disability assessed with the 100 point neck disability index; ; Measured at 2 months, 4 months and 15 months from baseline. SECONDARY OUTCOME: Treatment satisfaction, assessed on a five point scale: 1 = very satisfied, 2 = satisfied, 3 = equivocal, 4 = unsatisfied, and 5 = very unsatisfied; Scores of 1 and 2 are classified as "satisfied" and scores of 4 and 5 as "unsatisfied.; ; Measured at 2 months, 4 months and 15 months from baseline. INCLUSION CRITERIA: 1. Aged 18 years and older, either sex 2. Neck pain symptoms for longer than 3 months 3. Referred to therapy with a new episode of neck pain by their general practitioner (GP). Non‐specific neck pain is defined as pain and/or stiffness in the cervical spine, with or without unilateral arm pain, after the exclusion of red flags.