Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study

Arch Phys Med Rehabil. 2009 Oct;90(10):1734-9. doi: 10.1016/j.apmr.2009.05.012.

Abstract

Escolar-Reina P, Medina-Mirapeix F, Gascón-Cánovas JJ, Montilla-Herrador J, Valera-Garrido JF, Collins SM. Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study.

Objective: To assess the relative influence of information provided during physical therapy on a patient's adherence to self-management strategies in relation to other predictors of adherence (patient and pain characteristics, use of self-management strategies before intervention).

Design: A longitudinal observational study of the relationship between the information provided during physical therapy and adherence to self-management strategies.

Setting: Data came from a clinical-based population in 8 primary health care centers.

Participants: Patients (N=184) with chronic neck or low back pain (77% under the age of 59y) were surveyed at the beginning and 1 month after completion of physical therapy.

Interventions: Not applicable.

Main outcome measures: Specific and overall adherence to 2 types of strategies: (1) nonpharmacologic pain management strategies, and (2) neck/back care in activities of daily life.

Results: Adherence to strategies of nonpharmacologic self-management of pain was more probable when patients received information explaining the effectiveness of the self-management strategies (adjusted odds ratio [AOR]=10.1; P<.05) and information about their illness (AOR=3.4; P<.05) during clinical encounters. Information provided by the physical therapist did not have any influence on the adherence to neck/back care in activity of daily life (P>.05).

Conclusions: Information provided during clinical encounters is associated with adherence to different kinds of self-management strategies. While further study is required, it is suggested that more attention be given to clinical practice strategies for improving adherence to self-management of chronic pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Longitudinal Studies
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Neck Pain / rehabilitation*
  • Patient Compliance / statistics & numerical data*
  • Patient Education as Topic*
  • Physical Therapy Modalities*
  • Self Care / statistics & numerical data*
  • Young Adult