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  • New Study: Steroid Treatments Shouldn't Be the 'First-Line Stand-Alone' Approach to Neck Pain

    Authors of a new study say that epidural steroid injections used as a stand-alone treatment should not be a "first line" approach to cervical radicular pain, and instead suggest that a combination of treatments including physical therapy may offer the best chances for improvement.

    In a multicenter, randomized study published in the November issue of Anesthesiology, researchers tracked treatment outcomes for 3 groups of patients with neck pain that radiated through the shoulders and arms. A total of 55 patients received epidural steroid injection (ESI); 59 received pain medication and physical therapy; and 55 had both treatments. The study measured pain scores at outset, and 1, 3, and 6 months after treatments began.

    What researchers found was that both the conservative and steroid-only treatment groups improved at the same rate, and that while patients in the combination group reported greater rates of pain reduction, "the difference reached statistical significance only at 3 months." At that measurement point, 56.9% of the combination group reported decreased arm pain, compared with 36.7% of the steroid-only group and 26.8% of the conservative treatment group.

    "The main finding is that although the combination group experienced superior results for some outcome measures compared with stand-alone therapies, most differences generally fell shy of statistical significance, including for the primary outcome measure," authors write. "On the basis of these findings and the risks associated with ESI, one might reasonably conclude that ESI should not be a first-line, stand-alone treatment for cervical radiculopathy."

    Although authors did acknowledge that the combination group seemed to fare better than the stand-alone groups, they noted that "the effect size was more modest than we anticipated." Still, they offer several explanations for the differences, including the ways the treatments may enhance each other, the potential placebo effect of experiencing all treatments offered in the study, and the possibility that ESI treatments "provide significant short-term pain relief that allows optimal participation in [physical therapy], which provides long-term benefit."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    APTA Candidate Nominations Due by November 3

    APTA's strong and diverse leadership can continue—but only with your help.

    The APTA Nominating Committee is seeking candidates for the 2015 slate for the open positions of president, vice president, 3 directors, and a Nominating Committee member. The committee encourages APTA members to fill out an online nomination form (NC1) to identify leaders eager to serve in a national position. Deadline is November 3.

    But don't stop there. Once you've submitted your nominations, be sure to reach out to your nominees to encourage them and tell them exactly why you think they have what it takes to help APTA achieve its vision of transforming society.

    Time to Pick the Next PT in Motion Cover

    It's time once again for members to help PT in Motion magazine decide the design to be used on the cover of the upcoming issue. For December/January, editorial staff is proposing 3 designs and asking members to vote on their favorite cover to illustrate the concept of "pioneering PTs." The design that receives the most votes will be the next cover.

    Take the quick and simple survey by November 3. Just pick the design you think is likely to get you to open up the magazine, and then check out the December/January issue to see which cover was most popular.

    Don't Miss Miami – Marquette Challenge Student Social at NSC

    Attending the National Student Conclave October 30 – November 3 in Milwaukee? Don't miss the Miami – Marquette Challenge Student Social on Thursday 7:00 pm–10:00 pm.

    There's no admission charge. If you submitted your RSVP, a brown ticket to the event will be included with your conference badge then head over to Buckhead Saloon, 1044 Old World 3rd Street, to hang out, catch up, see, be seen, and get excited about this year's Challenge to benefit physical therapy research. For those who didn't RSVP, additional tickets will be given out onsite to the first 100 students arriving.

    Need more incentive? Free drink tickets will be handed out to the first 350 students who arrive. Buckhead Saloon is also offering $2 drink specials throughout the evening.