Prevalence, practice patterns, and evidence for chronic neck pain.
OBJECTIVE
To estimate the prevalence of chronic neck pain in North Carolina, to describe health care use (providers, treatments, and diagnostic testing) for chronic neck pain, and to correlate health care use with the current best evidence.


METHODS
We used data from a cross-sectional telephone survey of a representative sample of North Carolina households in 2006. A total of 5,357 households were contacted in 2006 to identify 141 noninstitutionalized adults ages ≥21 years with chronic neck pain and no chronic low back pain. The subjects were interviewed about their health and health care use (i.e., provider, tests, and treatments). Patterns of health care use were compared with current systematic reviews.


RESULTS
The estimated prevalence of chronic neck pain in 2006 among noninstitutionalized individuals for the state of North Carolina was 2.2% (95% confidence interval [95% CI] 1.7-2.6). Individuals with chronic neck pain were middle-aged (mean age 48.9 years) and the majority of subjects were women (56%) and non-Hispanic white (81%). The subjects saw a mean of 5.21 (95% CI 4.8-5.6) provider types and had a mean of 21 visits. The types of treatments subjects reported varied, with treatments such as electrotherapy stimulation (30.3%), corsets or braces (20.9%), massage (28.1%), ultrasound (27.3%), heat (57.0%), and cold (47.4%) having unclear or little benefit based on the current best available reviews.


CONCLUSIONS
Based on the current evidence for best practice, our findings indicate overutilization of diagnostic testing, narcotics, and modalities, and underutilization of effective treatments such as therapeutic exercise.
Duke University School of Medicine, Durham, North Carolina, USA. Adam.goode@duke.edu
Adam P
AP
Goode
Janet
J
Freburger
Timothy
T
Carey
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies / Q000379:methods; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D055815:Young Adult