Determinants, characteristics and treatment of neck pain in a tertiary care hospital in Kerala

Abstract

Background: This study was undertaken to study the determinants, clinical characteristics and treatment pattern of neck pain in patients attending outpatient department of Physical medicine and Rehabilitation in a tertiary care hospital.Methods: Study comprehended single patient visit. Data regarding patient demographics, characteristics of neck pain and clinical diagnosis, drugs prescribed to each patient were recorded in a pre prepared proforma. Clinician’s opinion about patient’s X-ray of cervical spine and the data regarding alternative treatment modalities were also noted. Data analysis was done with the help of excel 2007 and SPSS 16 statistical software.Results: Among 170 patients included in the study 38.8% of patients were in the age group of 40-49 years with M:F ratio-1:2.9. 98.8% of patients experienced radiation of neck pain to one or both arms. Neck pain also was associated with numbness in arm (82.4%), forearm (61.8%) or hand (59.4%) and neck stiffness (99.4%). Half of the study population were found to have neurological deficit. 98.2% of patients had positive radiological evidence for neck pain. Cervical spondylosis (85.9%) was the most commonly observed cause for neck pain. All patients received pharmacotherapy with NSAIDS and muscle relaxants. Diclofenac was the most commonly prescribed NSAID. 45% of the patients received alternative and complementary treatments for neck pain.Conclusions: NSAIDs and central skeletal muscle relaxants are the commonly prescribed medications and alternative treatments like spinal manipulation and physiotherapy appears to be beneficial in patients with neck pain.

Features of Neck Pain and its Related Factors Among Patients With Cervical Spondylosis

“…Another study also found the association between neck pain and numbness in arm, forearm and hands. 21,30 In this research, many patients reported that their pain was aggravated after flexion movement. Higher prevalence of neck pain was also observed in forward bending of the neck in a previous study.…”

“…Our study shows similarity with other studies where most of the patients were in the similar range of age suffering from neck pain. 10,17,20,21 Most of our patients were urban inhabitants (67.5%). Some other studies have also reported that the prevalence of neck pain was higher among urban population compared to the rural population.…”

“…nonsteroidal anti-inflammatory drugs [NSAIDs], muscle relaxants). 21,33 The main limitations of this study were that we have conducted only descriptive type of analysis, therefore, we failed to show any analytical details between different variables. Another limitation was the small sample size and the duration of study.…”

“…Higher prevalence of cervical spondylosis among females was also reported in many other studies. 6,[21][22][23] Most of our patients in this research were in the age group of 36 to 50 years. Our study shows similarity with other studies where most of the patients were in the similar range of age suffering from neck pain.…”

“…This finding was in accordance with other similar studies where cervical spondylosis found to be the most common cause of neck pain. 10,21,25,30 Another study in Bangladesh found that prevalence of symptoms was higher in hands/fingers among patients with cervical spondylosis. 20 In our study, we have also observed the involvement of right/left limbs or both among the patients.…”