Real-World Effectiveness of Physical Therapy for Common Neck Pain Diagnoses

Srikanth N. Divi, Ananth S. Eleswarapu, Christopher E. Stout, Michael J. Lee

Research output: Contribution to journalArticlepeer-review


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 2 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%.

Original languageEnglish (US)
Pages (from-to)395-399
Number of pages5
JournalClinical spine surgery
Issue number9
StatePublished - Nov 1 2018
Externally publishedYes


  • neck disability index
  • neck pain
  • numeric pain rating scale
  • patient-reported outcomes
  • physical therapy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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