Real-World Effectiveness of Physical Therapy for Common Neck Pain Diagnoses: A Multivariate Analysis of 1554 Patients

STUDY DESIGN: Retrospective cohort study (Level of evidence-3). OBJECTIVE: The objective of this study was to investigate the real-life effectiveness of physical therapy (PT) for patients initially presenting with common neck pain diagnoses. SUMMARY OF BACKGROUND DATA: Neck pain is a common cause of morbidity and a leading cause of disability in the United States. PT is prescribed as a first-line treatment for the vast majority of patients with neck pain; however, there is limited literature supporting the effectiveness of these treatments. METHODS: A total of 1554 patients enrolled in PT for the nonoperative treatment of neck pain were included in the study. Three primary patient-reported outcome (PRO) measures [neck disability index (NDI), resting numeric pain rating scale (NPRS), and activity NPRS] were recorded before and at conclusion of therapy. Improvement was noted if patients met a threshold value for a minimal clinically important difference (MCID). Bivariate analysis using a χ test and multiple logistic regression analysis were performed to determine risk factors predictive of treatment failure. RESULTS: About 40.5% of patients achieved MCID for NDI with an average change of -6.31 points. For resting NPRS and activity NPRS scores, 50.6% and 52.1% of patients achieved MCID with an average change of -1.93 and -2.36, respectively. After multiple logistic regression analysis, worker's compensation status was found to be an independent predictor for treatment failure in all groups; whereas, Medicare status was found predictive of achieving MCID in the activity NPRS group. CONCLUSIONS: We observed that up to half of the patients analyzed met the minimum criteria for improvement in neck pain with respect to the PRO measures, suggesting that real-life effectiveness of PT for common neck pain diagnoses may approach 50%.