Physical Activity May Be Underutilized For Chronic Back, Neck Pain

While individually tailored, supervised exercise programs are found to be associated with minimizing disabilities, a new study from University of North Carolina at Chapel Hill has revealed that there is a lack of knowledge, and physical activity may be underutilized for chronic back and neck pain.

During the study, the team led by Timothy S. Carey and Janet K. Freburger conducted a telephone survey of almost 700 individuals with chronic back or neck pain who saw a physician, chiropractor and/or physical therapist (PT) during the previous 12 months.

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They asked participants whether they were prescribed exercise, the amount of supervision received, and the type, duration and frequency of the prescribed exercise.

"Less than 50 percent of the subjects in our sample were prescribed exercise, one of the few moderately effective therapies for the highly disabling illness of chronic back and neck pain," said the authors.

The type of provider also played a major role in whether participants received a prescription.

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“Of those who received exercise prescription, 46 percent received the prescription from a PT, 27 percent from a physician, and 21 percent from a chiropractor,” they added.

Although most of the participants had seen a physician, only 14 percent were prescribed exercise. Some of those who were not prescribed exercise by a physician, however, were likely referred to a PT who did prescribe exercise.

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For those who were prescribed exercise, the type of provider seen determined the amount of supervision and, to some extent, the types of exercises prescribed.

Pts were more likely to provide supervision and prescribe stretching and strengthening exercises, practices which follow current guidelines and lead to better outcomes.

"Considering current evidence on the efficacy of exercise, these findings demonstrate that exercise is being underutilized as a treatment for chronic back and neck pain," the authors state.

"Although exercise prescription provided by Pts appears to be the most in line with current guidelines, there is much room for improvement by all types of providers who prescribe exercise for patients with chronic back and neck pain," they added.

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