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Hi,
The weather has been on my mind, so I did a trawl round the net and will show some of the good stuff before I get back to my own thoughts. Some thing from Med page today
enjoy
Medical News: Back Pain

Exercise Is Neglected Therapy for Chronic Low Back and Neck Pain
By Michael Smith, North American Correspondent, MedPage Today
Published: January 30, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit
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CHAPEL HILL, N.C., Jan. 30 -- Less than half of patients with chronic low back or neck pain are prescribed exercise, one of the few moderately effective interventions, researchers here said. Action Points
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Explain to interested patients that exercise has been shown to be moderately beneficial for chronic low back pain, but less is known about how often such an intervention is used.


Note that this study found that less than half of the patients who could benefit from exercise are getting a prescription for it.
In a survey of nearly 700 patients with chronic low back or neck pain, only 14.4% were prescribed exercise by their physicians, Janet Freburger, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues reported in the February issue of Arthritis Care & Research.


Physical therapists, on the other hand, were more likely to prescribe exercise to such patients as were chiropractors.


Although studies over the past 10 years have shown that exercise is beneficial for chronic low back and neck pain, Dr. Freburger and colleagues said, "less is known about exercise prescription in routine clinical practice. Who is prescribing it? Who is getting it? What is being prescribed?"


So they conducted a telephone survey, part of a larger study of the prevalence of chronic back and neck pain in North Carolina, the researchers said.


For this analysis, the researchers studied patients with chronic back or neck pain who completed the exercise section of the survey and who in the previous year had consulted a physician, chiropractor, or physical therapist.


All told, the sample included 684 patients, including 574 with chronic back pain and 110 with neck pain.


But only 48% of the patients were prescribed exercise, the researchers found, and -- although most saw a physician -- only about one in every seven said the physician suggested exercise.


In contrast, 63.8% of those who saw a physical therapist and 33.1% of those who saw a chiropractor were prescribed exercise.


In a multivariable analysis, physical therapists and chiropractors were significantly more likely than physicians (P<0.001 for both comparisons) to prescribe exercise.


Other significant predictors of an exercise prescription, the researchers found, were female sex, having greater than a high school education, and being on workers' compensation, at P=0.004, P=0.007, and P=0.01, respectively.


To be sure, many physicians who did not prescribe exercise referred the patients to physical therapists who did. Of those respondents who saw a physician and did not receive exercise instruction, 26.3% saw a therapist and 9.7% saw a chiropractor who did prescribe exercise, the researchers found.


Among the subset of patients who were prescribed exercise, the researchers found, physicians played a larger role. The investigators said 28.6% of respondents reported they got the suggestion from their physician, compared with 46% from a physical therapist and 20.9% from a chiropractor. Another 4.6% said they got the suggestion from more than one provider or did not specify a source.


Among the study limitations, the researchers said, is that they relied on patient self-report of exercise prescription, type, frequency, and duration.


The study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Agency for Healthcare Research and Quality, and the National Institute of Nursing Research. The authors did not report any conflicts.

Hope this is of interset. More to follow soon
Paul.
Dont forget, always got stuff at www.backpainloss.com