Chronic Neck Pain and High Medical Resource Utilization
Monday, November 1, 2010 at 10:23PMA recent study published in Arthritis Care and Research investigated health care utilization among patients with chronic neck pain.
The authors looked at patterns of health care use (providers, treatments and diagnostic testing) for a sample population in North Carolina with chronic neck pain. They attempted to correlate health care use with current best evidence and practice recommendations.
The study found that “Patients with chronic neck pain are overutilizing unproven and questionable therapies and underusing modalities for which there is evidence.”[1] For example, almost one-third of patients sampled were taking narcotic medications, despite the fact that the evidence for medications in neck pain is "extremely limited."[2] In contrast, “only about half had been prescribed therapeutic exercises during the past year -- a treatment for which a Cochrane review found good evidence.” [3] The fewest number of patients, only 2.7% had attempted acupuncture which has positive evidence for effectiveness.
A few specific findings from the study include:
- With regard to healthcare utilization, 79.3% had consulted at least one provider for their neck pain during the previous year, and among these patients, more than 90% had seen a physician
- Frequent consultation with multiple types of providers was common, with an average of five providers per patient and 21 visits
- Imaging tests also were prevalent, with 45% of patients having had x-rays, often more than once, as well as 24% having CT scans and 30% undergoing MRI
- 56% reported having a depressed mood
The researchers concluded that this patient population exhibits high use of healthcare resources, yet continues to have considerable disability.
Maybe there is something better to offer people with chronic neck pain. More exercise or acupuncture or posture modification. And fewer narcotics.
[1] Arthritis Care Res (Hoboken).2010 Jun 2. [Epub ahead of print]
[2] Arthritis Care Res (Hoboken).2010 Jun 2. [Epub ahead of print]
[3] Arthritis Care Res (Hoboken).2010 Jun 2. [Epub ahead of print]
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