Effective Neck Pain Treatments May Be Underutilized

Meanwhile, diagnostic imaging, narcotics, and unproven treatments are overused, study finds

MONDAY, Nov. 1 (HealthDay News) -- Diagnostic testing, narcotics, and questionable treatment modalities appear to be overused for chronic neck pain, while effective treatments such as therapeutic exercise appear to be underutilized, according to a study in the November issue of Arthritis Care & Research.

Adam P. Goode, P.T., of the Duke University School of Medicine in Durham, N.C., and colleagues assembled data from a telephone survey of 5,357 North Carolina households in 2006. The researchers analyzed responses for 135 adults aged 21 years and older with chronic neck pain but no low back pain.

The researchers found that spinal radiographs were performed for 45.1 percent of patients, magnetic resonance imaging for 30.2 percent, and computed tomography for 24 percent. Over-the-counter medications (nonsteroidal anti-inflammatory drugs) were used by 56.3 percent of patients, while 28.8 percent reported taking strong narcotics (morphine, oxycodone) and 23.1 percent took weak narcotics (codeine, propoxyphene). Many of the respondents had treatments that have not been proven or have been shown to be of little benefit, such as electrotherapy stimulation (30.3 percent), corsets or braces (20.9 percent), massage (28.1 percent), ultrasound (27.3 percent), heat (57.0 percent), and cold (47.7 percent). Just 53 percent had therapeutic exercise instruction, for which there is good evidence of benefit.

"Based on current evidence for best practice, our findings indicate over utilization of diagnostic testing, narcotics and modalities, and the under utilization of effective treatments such as therapeutic exercise," the authors write.

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