- Title
- People seeking treatment for a new episode of neck pain typically have rapid improvement in symptoms: an observational study
- Creator
- Farrell, Scott
- Relation
- New Zealand Journal of Physiotherapy Vol. 41, Issue 2, p. 73
- Relation
- http://physiotherapy.org.nz/professional-development/publications/nz-journal-of-physiotherapy/open-access-nz-journal-of-physiotherapy/2013-july-vol-41-no-2/#.VEbm7RaSHbw
- Publisher
- Physiotherapy New Zealand
- Resource Type
- journal article
- Date
- 2013
- Description
- Objective: To investigate the clinical course of a new case of non-specific neck pain, when treated by a primary care manual therapy practitioner. Methods: An observational study was undertaken involving 181 participants aged 18-70 years (mean 38.8 years) with a new case of non-specific neck pain, who sought treatment from a physiotherapist or chiropractor at one of 11 clinics in Sydney, Australia. Recruitment was undertaken in the context of a concurrent randomised trial comparing the effectiveness of two manual therapy techniques in the treatment of acute neck pain (Leaver et al 2010). Participants were excluded from the sample if their neck pain was related to trauma (e.g. motor vehicle accident); distal symptoms were the primary complaint; they had a history of neck surgery; neck pain severity was rated less than 2 on a 0-10 visual analogue scale (VAS); or they demonstrated signs of sinister or specific pathology (e.g. fracture, malignancy). Participants received four treatment sessions over two weeks from an experienced physiotherapist or chiropractor, comprising manipulation or mobilisation (depending on trial group allocation), as well as exercise prescription, electrophysical agents and/ or activity modification advice, at the discretion of the treating clinician. Participants completed baseline questionnaires detailing demographic and clinical variables at their initial appointment, and over a three-month period, used standardised diaries to record severity of pain (0-10 VAS) and activity limitation. Telephone interviews were conducted throughout the three-month period, including an exit interview. Pain and activity recovery times, pain and disability at three months, and clinical and demographic prognostic factors were the primary outcome measures. Results: Mean pain scores improved from a baseline of 6.1 (SD 2.0) to 2.5 (SD 2.0) at two weeks, to 1.5 (SD 1.8) at three months, with 53% of participants indicating their neck pain had completely recovered by the end of the study. Mean disability (quantified on a 0 to 50 scale) decreased from 15.5 (SD 7.4) initially to 5.4 (SD 6.4) at three months. Factors associated with faster recovery were better self-rated general health, shorter duration of symptoms, being a smoker, and no concurrent head or upper back pain. Factors associated with higher disability at three months were older age, higher baseline disability, concurrent back pain, and previous sick leave for neck pain. Conclusion: Patients suffering a new case of non-specific neck pain that undergo physiotherapy/chiropractic manual therapy treatment generally demonstrate a rapid decrease in pain severity. Lingering pain and disability are relatively uncommon, and a number of prognostic indicators can identify those patients at risk of ongoing disability. This information can serve to guide clinicians and to reassure patients in a primary care setting.
- Subject
- non-specific neck pain; manual therapy; primary care; treatment
- Identifier
- http://hdl.handle.net/1959.13/1052686
- Identifier
- uon:15465
- Identifier
- ISSN:0303-7193
- Language
- eng
- Full Text
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