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The management of chronic neck pain in general practice. A retrospective study
J Borghouts1, H Janssen, B Koes
1Institute for Research in Extramural Medicine (EMGO), Vrije Universiteit, Amsterdam, The Netherlands.
Objective:
To describe the management in patients with chronic non-specific neck pain in general practice.
Design:
A descriptive, questionnaire-based retrospective study.
Setting:
General practices in the Netherlands.
Patients:
517 patients with chronic non-specific neck pain.
Main Outcome Measures:
Nature and frequency of diagnostic procedures, therapeutic interventions and referrals by the general practitioner (GP).
Results:
Forty-four per cent visited the GP for neck pain in the previous year. Of the patients who did visit the GP in the previous year, 32% did not receive a diagnostic modality, 31% did not receive therapy and 43% were not referred. The most frequently applied diagnostic and therapeutic modalities were physical examination (66%) and pain medication (58%), respectively. The GPs most frequently referred to a physiotherapist (51%).
Conclusion:
Once neck pain has become chronic, the minority (44%) of patients do seek help from their GP on a yearly base. In spite of the fact that the patients' conditions are non-specific and chronic, GPs still find indications for further diagnostics in two-thirds of patients. The GPs were rather consistent in their management, as the nature of the diagnostic/therapeutic modalities and referrals was similar in more than 50% of the patients.