Self-management of persistent neck pain: A randomized controlled trial of a multi-component group intervention in primary health care

The objective of this study was to compare treatment effects of (a) a multi-component pain and stress self-management group intervention (PASS) and (b) individually administered physical therapy (IAPT) for patients with persistent musculoskeletal tension-type neck pain. 156 persons seeking physical therapy treatment due to persistent tension-type neck pain at nine primary health care centers in Sweden were randomly assigned to either PASS or IAPT. Before treatment (baseline) and at 10- and 20-weeks the participants completed a self-assessment questionnaire comprising: the Self-Efficacy Scale, the Neck Disability Index, the Coping Strategies Questionnaire, the Hospital Anxiety and Depression Scale, the Fear-Avoidance Beliefs Questionnaire and questions regarding neck pain, analgesics and utilization of health care. Intention-to-treat analyses were performed using repeated measures analysis of variance between baseline, 10-week and 20-week follow-up. On average participants receiving PASS attended seven treatment sessions and participants receiving IAPT 11 sessions over the 20-week follow-up period. Repeated measures ANCOVA showed significant time × group interaction effects for ability to control pain, self-efficacy regarding pain-interfering activities, disability due to neck pain and levels of catastrophic thinking in favour of PASS.

PASS had a better effect than IAPT in the treatment of persistent musculoskeletal tension-type neck pain regarding coping with pain, in terms of patients’ self-reported pain control, self-efficacy, disability and catastrophizing, over the 20-week follow-up.

Catharina Gustavsson, Eva Denison and Lena von Koch. Self-management of persistent neck pain: A randomized controlled trial of a multi-component group intervention in primary health care. European Journal of Pain, 25 November 2009, online article ahead of print

Sensorimotor Impairment in Neck Pain

Join Chris Worsfold in this short online course to learn about the evaluation and rehabilitation of sensorimotor impairment in patients with neck pain.