Systematic review finds aerobic exercise combined with other therapies helps reduce neck pain intensity and improve physical function in adults

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Experimental physiology Published June 4, 2026 Medically reviewed June 4, 2026 Study authors: de Oliveira-Souza Ana Lzabela Sobral, Kempe Marie, Grimmelsmann Sofia, Tavares Luiz Felipe, De Castr… PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Combined aerobic exercise with other therapies reduces neck pain better than isolated treatments, though standalone aerobic exercise showed no significant benefit.

A comprehensive systematic review and meta-analysis evaluated the role of aerobic exercise for adults suffering from neck pain. Researchers analyzed data from six published studies, initially screening over four thousand records to identify relevant trials. The primary focus was on measuring pain intensity and physical function outcomes.

Results indicated that aerobic exercise performed in isolation did not differ statistically from no treatment or other interventions like acupuncture. The mean difference in pain scores showed a wide confidence interval that included zero, suggesting no clear advantage for standalone aerobic activity in this specific context.

Conversely, strengthening exercises demonstrated superior effectiveness for pain reduction compared to aerobic exercise alone. Most notably, combined therapy approaches involving aerobic exercise alongside other treatments yielded significantly better results than isolated interventions. This suggests a synergistic effect when integrating different therapeutic modalities.

The evidence quality was assessed as low due to high heterogeneity across study protocols and comparisons. No adverse events or discontinuations were reported, indicating a favorable safety profile. Clinicians should consider combining aerobic exercise with other established therapies to maximize benefits for patients with neck pain.

Study Details

Study typeMeta analysis

EvidenceLevel 1

Follow-up216.0 mo

PublishedJun 2026

PMID39560389

View Original Abstract ↓

The present review aimed to investigate the effectiveness of aerobic exercise (AE) compared to other interventions in decreasing pain intensity and reducing disability in individuals with neck pain. A systematic review (SR) of randomized controlled trials was conducted. This SR was registered in PROSPERO (CRD42021231231). Searches were conducted in five electronic databases (MEDLINE, Embase, CINAHL, Cochrane and SCOPUS). Studies were selected if they included adults over 18 years old with neck pain. The primary outcomes were pain intensity and physical function. A meta-analysis was conducted when applicable. Cochrane RoB Tool-2 was used to determine the risk of bias of included studies, and the certainty of the evidence was determined using the GRADE approach. Out of 4669 initial records screened, six studies published in 12 articles were included. AE was not statistically different compared to no-treatment or other interventions (e.g., localized exercise or acupuncture) on pain intensity measured with a visual analogue scale (VAS) (mean difference (MD) [95%CI]: 5.16 mm [-6.38, 16.70]). Contrarily, strengthening exercise was better than AE for pain intensity (MD [95%CI]: -11.34 mm [-21.6, -1.09]) after treatment. However, when AE was combined with other therapy (strengthening exercises or acupuncture), the combined therapy was better than isolated treatments (MD [95%CI]: 7.71 mm [1.07, 14.35]). A high heterogeneity was observed between protocols, comparisons, and results (magnitudes and directions). In conclusion, AE had positive results only when combined with other therapies to reduce pain intensity and disability in patients with neck pain. However, the evidence is limited, low-quality, and heterogeneous.