Affiliations: [a] University Health Network, Toronto, ON, Canada | [b] School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada | [c] Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada | [d] School of Physical Therapy, Western University, London, ON, Canada | [e] Department of Clinical Epidemiology and Biostatistics, McMaster University Evidence-based Practice Centre, Hamilton, ON, Canada
Correspondence:
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Corresponding author: Lisa Carlesso, Toronto Western Research Institute, University Health Network, 399 Bathurst Street - MP11-328, Toronto, ON M5T 2S8, Canada. Tel.: +1 416 603 5800 x5665; Fax: +1 416 603 6288; E-mail:lccarlesso@gmail.com
Abstract:
BACKGROUND: Examination of practice patterns compared to existing
evidence identifies knowledge to practice gaps. OBJECTIVES: 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. CONCLUSION: 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.
Keywords: Survey, neck pain, treatment, practice patterns, patient education, psychology
