Yin & Bogduk

[ampaphb]

The nature of neck pain in a private pain clinic in the United States
Yin W, Bogduk N
Pain Med. 2008 Mar;9(2):196-203

Objective. To determine the prevalence of different causes of neck pain in a private practice clinic.

Design. A retrospective audit of records.

Setting. A private spine pain clinic in the state of Washington, USA.

Patients. All consecutive patients, seen between January 2003 and January 2005, in whom a diagnosis of neck pain was made.

Interventions. The records of all patients were examined to determine the prevalence of various diagnostic entities determined by history, examination, and invasive test such as controlled diagnostic blocks and provocation discography.

Outcome Measures. Using different denominators, the prevalence of various conditions was determined in all patients who presented with neck pain, in patients in whom investigations were undertaken, and in patients who completed investigations.

Results. A large proportion of patients (36%) did not pursue investigations, which diluted the crude prevalence of various conditions. A further 17% deferred completing investigations. Among the 46% of patients who completed investigations, the prevalence of zygapophysial joint pain was 55%, discogenic pain was 16%, and lateral atlanto-axial joint pain was 9%. A diagnosis remained elusive in only 32% of those patients who completed investigations.

Conclusions. In a private practice setting, a patho-anatomic diagnosis for chronic neck pain can be established in over 80% of patients, provided that appropriate investigations are undertaken. The prevalence of cervical zygapophysial joint pain encountered in the present study corroborates the prevalence rates established in academic studies. Cervical discogenic pain does not appear to be common among patients with chronic neck pain.

---

Members don't see this ad.

 

[ampaphb]

The nature of neck pain in a private pain clinic in the United States
Yin W, Bogduk N
Pain Med. 2008 Mar;9(2):196-203

Objective. To determine the prevalence of different causes of neck pain in a private practice clinic.

Design. A retrospective audit of records.

Setting. A private spine pain clinic in the state of Washington, USA.

Patients. All consecutive patients, seen between January 2003 and January 2005, in whom a diagnosis of neck pain was made.

Interventions. The records of all patients were examined to determine the prevalence of various diagnostic entities determined by history, examination, and invasive test such as controlled diagnostic blocks and provocation discography.

Outcome Measures. Using different denominators, the prevalence of various conditions was determined in all patients who presented with neck pain, in patients in whom investigations were undertaken, and in patients who completed investigations.

Results. A large proportion of patients (36%) did not pursue investigations, which diluted the crude prevalence of various conditions. A further 17% deferred completing investigations. Among the 46% of patients who completed investigations, the prevalence of zygapophysial joint pain was 55%, discogenic pain was 16%, and lateral atlanto-axial joint pain was 9%. A diagnosis remained elusive in only 32% of those patients who completed investigations.

Conclusions. In a private practice setting, a patho-anatomic diagnosis for chronic neck pain can be established in over 80% of patients, provided that appropriate investigations are undertaken. The prevalence of cervical zygapophysial joint pain encountered in the present study corroborates the prevalence rates established in academic studies. Cervical discogenic pain does not appear to be common among patients with chronic neck pain.

53% drop-out rate! If the authors had been anyone her than Yin and Bogduk, do you really think it would have been accepted for publication?

 

[Mister Mxyzptlk]

What they really showed (based on what was posted here) was that you can identify an etiology in 80% of compliant patients.

From an intent-to-treat perspective, they should conclude that an identifiable pain source can be found in 38% (80% of 47%) of patients who present to a private pain practice with neck pain.