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News > Drug-free Treatment Best for Chronic Neck Pain
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Drug-free Treatment Best for Chronic Neck Pain

A new study shows doctors may order too many tests and over-prescribe drugs when therapeutic exercise may be the most effective treatment for neck pain.

By Jennifer Davis

11/17/10 A new study says doctors often bypass effective treatments for chronic neck pain – like therapeutic exercise – and instead prescribe strong medicine and conduct diagnostic tests that may be unnecessary.

“It’s a problem from the standpoint that some folks may not be utilizing highly effective treatments and some folks may be continuing to use ineffective treatments. We are trying to make evidence more aware to patients and providers,” explains Adam Goode, an assistant professor of physical therapy at Duke University in Durham, N.C.

In the November issue of Arthritis Care & Research, Goode and his colleagues from Duke University and the University of North Carolina sorted through data from a 2006 telephone survey of more than 5,000 homes in North Carolina. They identified 140 people who had been experiencing chronic neck pain for nearly seven years. The patients’ search for relief involved, on average, about 21 visits with five different kinds of health care providers, 1.6 diagnostic tests and more than three different types of treatment.

More than 56 percent of participants said they had used over the counter medications to relieve their neck pain, 29 percent had taken strong opioid painkillers, such as oxycodone, and 23 percent had used weaker opioids, such as codeine – but their pain persisted. Researchers say that’s not surprising: A review of scientific literature in The Cochrane Library and The Bone and Joint Decade 2000-2010 shows medicine has limited effectiveness in treating chronic neck pain.

“I think it indicates there’s a disconnect between what we know to be effective and what people are using in the population. But why that is occurring we can’t answer in the study,” Goode says.

Forty-five percent of participants had spinal radiographs, 30 percent had MRIs and 24 percent had CT scans. But just more than half the participants were prescribed therapeutic exercise, which generally involves physical therapy for muscles that support a painful area. Studies have shown physical therapy, as well as acupuncture, are effective at reducing chronic neck pain.

“For the most part, a lot of things that have limited effectiveness are being overused and things with high effectiveness like therapeutic exercise are being underused. It gives us an idea of what’s going on. This is the first type of study that’s looked at that,” Goode explains.

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Mary
28 Dec 2011, 21:10
As a person with arthritis and low and upper back problems I agree with most of this article. However, I would like to add some thoughts from my perspective. I agree that pain medicine alone is an ineffective way to treat chronic pain. I have been in severe chronic pain for more than twenty years. It takes an interdisciplinary approach to pain control. Especially with arthritis physical activity is like walking a tightrope. Too little activity and the muscles atrophy. Too much activity and I may suffer another problem with my ACL tears and maybe a fall and --whoops! There goes my back.
My back ALWAYS hurts, but water therapy and massage helps. On less stressful days sometimes I am only taking one pill. Other days I have to take what has been prescribed. It is hard to know how to regulate dosages as the human body and especially a person with arthritis is not the same on any given day. Even a slight change in the barometric temperature can change the way a person with arthritis feels. Diet is extremely important to a person with arthritis. And, each person is unique like our fingerprints are. What one person thrives on may kill another. From my own experience I know some foods will make me wish I were dead within an hour of eating them my fingers, etc begin to swell.
Pool therapy increases circulation and decreases pain. How wonderful it would be if doctors prescribed pool therapy and our insurances would pay for it! If meals for all individuals with severe arthritis could be provided for them that were tasty and nutritional and based upon their own unique DNA and personal needs. If doctors could have the time to educate their patients and provide feedback. If the doctors could prescribe what is needed for the patient instead of what is good for the drug companies. Instead of paid perks for the doctors to provide bad drugs those incentives could be given to the doctors and patients alike for their feedback in the various options that are out there people like me have yet to find.

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