Predicting Results of Physical Therapy Treatment For Neck Pain
Researchers from the Primary Care Musculoskeletal Research Centre in England have been conducting ongoing studies on neck pain. This article is the third in a series exploring predictors of treatment outcome.
A previous study done by this same group compared the results of three different physical therapy treatments for neck pain. They did not find significant differences in the results from group to group. Patients were followed up to six months after treatment with no change in results.
The purpose of this current study was to identify factors that predict poor outcome. The results were compared with what physical therapists (PTs) thought might be the psychosocial predictors of results.
A large number of patients (350) with neck pain were included in this study. Patients were evaluated based on social class, type of work, and type of pain (local versus widespread). General physical and mental health were measured using standard health surveys.
Outcomes were measured by patient report of change in neck pain (improved or not improved). Predictors of poor outcome (no improvement) included low patient expectations and catastrophizing symtpoms.
Patients who catastrophize symptoms describe their pain as terrible. They believe it's never going to get any better. The data from this study shows that PTs can consistently identify who these patients are and who will have a poor response to treatment.
The authors conclude that patients at risk for poor treatment results may need a different approach to physical therapy. Routine PT for neck pain is not likely to change the symptoms. Future studies may help find an approach that is successful with patients who have factors that predict a poor outcome.
Jonathan C. Hill, MSc, et al. Predictors of Poor Outcome in Patients with Neck Pain Treated by Physical Therapy. In The Clinical Journal of Pain. October 2007. Vol. 23. No. 8. Pp. 683-690.
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