Experts say exercise underutilized as treatment for back, neck pain
Researchers from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina conducted a survey of nearly 700 individuals with chronic back or neck pain who saw a physician, chiropractor and/or physical therapist during the previous 12 months. 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 Timothy S. Carey and Janet K. Freburger, lead researchers of the study.
According to the study, the type of provider played a major role in whether participants received a prescription. Of those who received an exercise prescription, 46 percent received the prescription from a physical therapist, 27 percent from a physician, and 21 percent from a chiropractor. The authors noted that these findings correlated with previous studies that have found that "who you see is what you get."
The study, published in Arthritis Care & Research, found that for those who were prescribed exercise and the type of provider seen determined the amount of supervision and, to some extent, the types of exercises prescribed. Physical therapists were more likely to provide supervision and prescribe stretching and strengthening exercises, practices which the researchers said follow current guidelines and lead to better outcomes.
The authors suggested that future studies explore barriers to prescription of exercise treatments, such as practitioner knowledge, organizational aspects of the practice, and poor reimbursement for exercise instruction compared with other types of treatment.
Second study supports exercise. In a second unrelated study published in The Spine Journal, researchers found that exercise in the workplace is effective in preventing new episodes of low-back problems.
"Strong and consistent evidence finds many popular prevention methods fail while exercise has a significant impact, both in terms of preventing symptoms and reducing back pain-related work loss," said Dr. Stanley J. Bigos, University of Washington professor emeritus of orthopedic surgery and environmental health.
April 9, 2009
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