Pharmacological, psychological, and patient education interventions for patients with neck pain: results of an international survey.
BACKGROUND
Examination of practice patterns compared to existing evidence identifies knowledge to practice gaps.


OBJECTIVE
To describe the utilization of pharmacological, patient education, primary psychological interventions and relaxation therapies in patients with neck pain by clinicians.


METHODS
An international cross-sectional survey was conducted to determine the use of these interventions amongst 326 clinicians treating patients with neck pain.


RESULTS
Nineteen countries participated. Results were analyzed by usage amongst physical therapists (39%) and chiropractors (35%), as they were the predominant respondents. Patient education (95%) and relaxation therapies (59%) were the most utilized interventions. Tests of subgroup differences determined that physical therapists used patient education significantly more than chiropractors. Use of medications and primary psychological interventions were reported by most to be outside of scope of practice. The high rate of patient education is consistent with supporting evidence. However, usage of relaxation therapies is contrary to evidence suggesting no benefit for improved pain or function for chronic neck pain.


CONCLUSIONS
This survey indicates that patient education and relaxation therapies are common treatments provided by chiropractors and physical therapists for patients with neck pain. Future research should address gaps associated with variable practice patterns and knowledge translation to reduce usage of interventions shown to be ineffective.
University Health Network, Toronto, ON, Canada.|School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
Lisa C
LC
Carlesso
School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
Anita R
AR
Gross
School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.|Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada.
Joy C
JC
MacDermid
School of Physical Therapy, Western University, London, ON, Canada.
David M
DM
Walton
Department of Clinical Epidemiology and Biostatistics, McMaster University Evidence-based Practice Centre, Hamilton, ON, Canada.
P Lina
PL
Santaguida
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010353:Patient Education as Topic; D012064:Relaxation Therapy; D012648:Self Care; D011795:Surveys and Questionnaires
D000700:Analgesics
Survey; neck pain; patient education; practice patterns; psychology; treatment