A questionnaire survey of the management and classification of patients presenting with neck pain to osteopathic and physiotherapy practices

Hutchinson, James
Reid, Duncan
Hing, Wayne
Moran, Robert
Item type
Degree name
Master of Philosophy
Journal Title
Journal ISSN
Volume Title
Auckland University of Technology

Background: Little is known about the management practices of Australian and New Zealand osteopaths and physiotherapists for patients with neck pain. By assessing the practice patterns of practitioners using a case-by-case approach it is possible to investigate the extent to which practitioners may be in alignment with best-practice guidelines. By identifying a practice-research gap it is possible to tailor educational and research efforts to improve management practices where necessary.

Aim: To survey the management approaches of Australian and New Zealand osteopaths and physiotherapists for patients with neck pain and describe their alignment with evidence-based practice.

Methods: A web-based questionnaire was administered from September 2012 to April 2013 to survey the intervention utilisation, and consistency with a treatment-based classification scheme amongst Australian and New Zealand osteopaths and physiotherapists treating patients with neck pain.

Results: The highest proportion of respondent practitioners (n=48) was from New Zealand (52%, n=25). Osteopaths accounted for 54% of the respondents and physiotherapists 46%. In the patient subset (n=109), osteopaths reported on n=51 patient interactions, and physiotherapists on n=58. The most frequently occurring age bracket for patients was 36-45 years (29%), and the patient subset was predominantly female (62%). The most frequently reported presenting complaint was neck pain and headache (35%). Odds ratio (OR) and Chi square (X2) analysis was performed to allow comparisons to be made between practitioner groups. Analysis indicated that both practitioner groups employed a multimodal approach in their management of patients with neck pain, with the interventions selected consistent with supporting evidence. Analysis of the classification subgroups showed a lack of evidence supporting practitioners applying a treatment-based classification system. Some of the interventions applied lacked evidential support in the literature. Osteopaths often applied a regional approach for the treatment of patients with neck pain, applying interventions more frequently than physiotherapists to the thoracic region as well as the cervical region.

Conclusion: The two groups of practitioners demonstrated a multimodal approach to their management of patients with neck pain and did not appear to apply groupings of interventions that were consistent with a treatment-based classification system. In addition, there were differences between osteopaths and physiotherapists in the frequency of utilisation of spinal manipulation, and the anatomical regions addressed.

Survey , Neck Pain , Osteopaths , Physiotherapists , Practice Patterns , Questionnaire , Practice patterns , Multimodal management , treatment-based classification
Publisher's version
Rights statement