Exercise is commonly used to improve physical function, decrease symptoms and minimize disability caused by chronic low back or neck pain. Numerous randomized trials and clinical practice guidelines have supported this practice, and studies suggest that individually tailored, supervised exercise programs are associated with the best outcomes.
Nevertheless, there is a lack of knowledge about exercise prescription, including who is prescribing it, who is getting it and what type of exercise is being prescribed. A new study, funded by the National Institutes of Health, examined these questions and found that exercise may be underutilized for chronic back and neck pain. The study was published in the February issue of Arthritis Care & Research.
Led by Timothy S. Carey and Janet K. Freburger of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, researchers conducted a telephone survey of almost 700 individuals with chronic back or neck pain who saw a physician, chiropractor and/or physical therapist (PT) during the previous 12 months. They asked participants whether they were prescribed exercise, the amount of supervision received, and the type, duration and frequency of the prescribed exercise.
"Less than 50 percent of the subjects in our sample were prescribed exercise, one of the few moderately effective therapies for the highly disabling illness of chronic back and neck pain," the authors state. The type of provider seen played a major role in whether participants received a prescription. Of those who received exercise prescription, 46 percent received the prescription from a PT, 27 percent from a physician, and 21 percent from a chiropractor. The authors note that these findings agree with previous studies that have found that "who you see is what you get."
Although most of the 700 participants had seen a physician, only 14 percent were prescribed exercise. Some of those who were not prescribed exercise by a physician, however, were likely referred to a PT who did prescribe exercise. Not surprisingly, Pts were the most likely to prescribe exercise, although about a third of those who saw a PT did not receive an exercise prescription.