The assessment and treatment of back and neck pain: an initial investigation in a primary care practice-based research network.
OBJECTIVE
The purpose of this study was to conduct an exploratory examination of the current state of non-malignant acute and chronic back and neck pain assessment and management among primary care providers in a multi-site, practice-based research network.


BACKGROUND
Acute and chronic pain are distinct conditions that often require different assessment and management approaches, however, little research has examined assessment and management of acute and chronic pain as separate conditions. The large majority of patients with acute and chronic back and neck pain are managed in primary care settings. Given the differences between acute and chronic pain, it is necessary to identify differences in patient characteristics, practitioner evaluation, treatment and management in primary care settings.


METHODS
Over a two-week period, 24 practitioners in a multi-site practice-based research network completed 196 data cards about 39 patients experiencing acute back and neck pain and 157 patients suffering from chronic back and neck pain. Findings There were significant differences between the patients experiencing acute and chronic pain in regards to practitioner evaluation, current medication management and current treatment for depression. In addition, diagnostics differed between patients experiencing acute versus chronic back and neck pain. Further, primary care providers' review of online drug monitoring program reports during the current visit was associated with current medication management using short term opioids, long-term opioids or tramadol. Most research examining acute and chronic pain focuses on the low back. Additional research needs to be conducted to explore and compare acute and chronic pain across the whole spine.
1Research Coordinator and Assistant ProfessorDepartment of Family and Community Medicine,Northeast Ohio Medical University,Ohio,USA.
Rebecca
R
Fischbein
2Research Director,Summa Barberton Hospital Family Practice Center.
Kenelm
K
McCormick
3Clinical Assistant Professor of Family and Community Medicine,Northeast Ohio Medical University,Ohio,USA.
Brian A
BA
Selius
7Assistant Dean of Curriculum,College of Medicine,Northeast Ohio Medical University,Ohio,USA.
Susan
S
Labuda Schrop
9Biostatistician,Instructor of Family and Community Medicine,Northeast Ohio Medical University,Ohio,USA.
Michael
M
Hewit
10Assistant Professor of Family and Community Medicine,Northeast Ohio Medical University,Ohio,USA.
Kristin
K
Baughman
11Graduate Assistant,Northeast Ohio Medical University,Ohio,USA.
James
J
Meeker
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000628:therapy*; D010147:Pain Measurement; D011320:Primary Health Care / Q000379:methods*; D012106:Research; D016896:Treatment Outcome; D055815:Young Adult
acute back and neck pain; chronic back and neck pain; non-malignant back and neck pain; primary care providers