The results indicate that psychological interventions delivered by physiotherapist show promise to improve health outcomes, particularly psychological outcomes, in musculoskeletal pain conditions.

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Objectives Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. Methods These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. Results A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes “successful treatment,” “reassurance,” and “trust”; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. Conclusions This detailed comparison provides information about neck pain patients’ concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients’ perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis.

Objectives The study aimed to identify and compare (1) what physical therapists perceive to be the main concerns, fears, and worries that patients with whiplash-associated disorders (WAD) and nontraumatic neck pain (NTNP) have as a result of their condition, and (2) the strategies used by physical therapists to address these fears and concerns. Methods Using convenience sampling, 30 physical therapists completed 2 online open-ended surveys. The responses were analyzed using 2 descriptive analytic methods (thematic analysis and constant comparative analysis), and then themes were examined for areas of convergence and divergence. Results Four similar themes for both neck pain groups were produced from our analysis of the survey responses: (1) interference with daily life, (2) concerns related to pain, (3) psychological distress, and (4) ``When I will recover?'' Subthemes differed between the groups. For example, the theme “psychological distress” had subthemes of anger and thoughts about no resolution for the WAD group, whereas for the NTNP group, subthemes were anxiety and uncertainty. The only divergent theme was (5) fear avoidance, present in the NTNP group only. Analysis of physical therapist strategies identified 3 consistent themes and 5 divergent themes across the 2 groups. Conclusions Physical therapists described a wealth of reassurance strategies for individuals with NTNP and WAD. There were several shared themes but also some discordant ones. Reassurance is multifactorial and needs to be nuanced and not prescriptive. Impact These qualitative findings may be key to inform the differentiated content of training programs for physical therapists delivering reassurance for these 2 populations.