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

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