Exercise for Chronic Back and Neck Pain
Doctors aren't prescribing it... but they should be
Researchers at the University of North Carolina at Chapel Hill recently discovered a conundrum: even though the medical community agrees that exercise (both stretching and strengthening exercises) is good for back pain, a majority of patients aren't prescribed exercise.
This finding was published in the February 2009 issue of Arthritis Care & Research; the article is "Exercise prescription for chronic back or neck pain: Who prescribes it? Who gets it? What is prescribed?"
How the Study Worked
As you can see from the title, the researches focused on chronic back pain and neck pain sufferers. They did a telephone survey of 684 chronic back or neck pain patients who had seen a physician, chiropractor, and / or physical therapist in the past 12 months. There were 574 chronic back pain patients and 110 chronic neck pain patients.
During the telephone interview, researchers asked patients:
- if they were prescribed exercise
- how much supervision the medical professional provided
- what type of exercises were prescribed
- how long they were supposed to exercise
- how often they were supposed to exercise.
The researchers then analyzed the data.
What the Study Found
The study found that just 48% of the participants were prescribed exercise. In that subset:
- 46% were prescribed exercise by a physical therapist
- 28.6% were prescribed exercise by a physician
- 20.9% were prescribed exercise by a chiropractor
- 4.6% were either prescribed exercise by more than one medical professional or they didn't give a specific source.
In the overall sample:
- 63.8% of people who saw a physical therapist were prescribed exercise
- 33.1% of people who saw a chiropractor were prescribed exercise
- 14.4% of people who saw a physician were prescribed exercise
The research showed that physical therapists are the most likely to prescribe exercise; that makes sense, given that a large part of what they do revolves around exercise. Researchers also found that physical therapists were the most likely to provide supervision to make sure their patients were doing the exercises and doing them correctly.
Physicians often refer their patients to physical therapy, knowing that they need to do stretching and strengthening exercises to help deal with their chronic pain; it's good to keep that in mind when looking at the data.
Yes, only 14.4% of physicians prescribed exercise, but of that 85.6% of patients who saw a physician and were not prescribed exercise, 26.3% of them then went to a physical therapist and were prescribed exercise. 9.7% of them went to a chiropractor and were told to do certain exercises.
What the Study Means
Think of this as a quality control check, a check-up on the medical professionals. They know what they're supposed to be doing—prescribing exercise in certain situations and cases, according to current guidelines—but how often are they really doing that?
Unfortunately, the study found that they aren't prescribing exercise as often as they should.
What You Can Do
If you have chronic back or neck pain, you're probably under a doctor's care. If you don't currently have an individualized exercise plan, talk to the doctor; be proactive in your healthcare. Ask if you should be doing certain exercises to help alleviate pain and keep your body strong.
- Freburger JK, Carey TS, Holmes GM, Wallace AS, Castel LD, Darter JD, Jackman AM. Exercise prescription for chronic back or neck pain: Who prescribes it? Who gets it? What is prescribed? Arthrit Care Res. 2009;61(2):192-200.