Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: ‘McKenzie’ vs brief physiotherapy pain management

J. Klaber Moffett,  D. A. Jackson, E. D. Gardiner, D. J. Torgerson, S. Coulton, S. Eaton, M. P. Mooney, C. Pickering, A. J. Green, L. G. Walker, S. May,  and S. Young

Interventions that take psychosocial factors into account are recommended for patients with persistent back or neck pain. This study compared the effectiveness of a brief physiotherapy pain management approach using cognitive-behavioural principles (Solution-Finding Approach–SFA) with a commonly used method of physical therapy (McKenzie Approach–McK).  Of 649 patients assessed for eligibility, 315 were recruited (219 with back pain, 96 with neck pain). There were no statistically significant differences in outcomes between the groups, except that at any time point SFA patients supported by a booklet reported less reliance on health professionals, while at 6 months McK patients showed slightly more improvement on activity-avoidance. At 6 weeks, patient satisfaction was greater for McK. Both interventions resulted in modest but clinically important improvements over time on the Roland Disability Questionnaire Scores and Northwick Park Neck Pain Scores.  The authors conclude that the McK approach resulted in higher patient satisfaction overall but the SFA could be more cost-effective, as fewer sessions were needed.

Rheumatology Advance Access published online on October 24, 2006

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