Evaluating the effectiveness of patient-tailored treatment for patients with non-specific (sub)acute neck pain

Abstract

Background

An important issue in the debate about best practice management of non-specific neck pain (NSNP) is the effectiveness of tailored versus generalized interventions.

Methods

Participants with (sub)acute NSNP were randomly allocated to a patient-tailored treatment (PTT), non-patient-tailored treatment (NPTT) or control group (no intervention). The outcome measures were pain (NPRS), disability (NDI), global perceived effect and satisfaction (GPES), productivity costs, and medical consumption. Patients were assessed at baseline, post-intervention, and at 3-, 6-, and 12-months post-intervention. Evolution of the complaints, treatment adherence, and medication intake was registered during the intervention period. Linear mixed models were used to examine interaction effects as well as between- and within-group differences.

Results

Sixty-one participants were included. There was no “Group x Time”-interaction effect for all outcome measures. Nevertheless, all groups showed significant and clinically relevant within-group differences at all time points for pain and disability (p < 0.001). At 6 months follow-up, NPTT was superior to PTT for reductions in pain but not for disability. At 1 year, the number of responders in the NPTT group remained higher (75%) compared to the PTT group (40%).

Conclusion

This study found a significant and clinically relevant reduction of pain and disability within all groups. Patient-tailored treatment as well as NPTT can be considered an effective method when aiming for a reduction in pain and disability at short-term (12 weeks). However, NPTT seemed to be more effective at 1-year follow-up and therapists should consider spontaneous recovery. The results should be interpreted with caution and further research is warranted.