Investigation of conservative treatment preferences of patients with chronic low back and neck pain

The aim of this thesis is to determine the preferences of individuals with chronic low back and neck pain regarding different conservative treatment methods, to explore the reasons behind these preferences, and to examine the effects of these preferences on clinical outcomes. A total of 100 participants, including 50 individuals with chronic low back pain and 50 with chronic neck pain, were included in the study. Participants were shown videos introducing the methods of "Electrotherapy Modalities," "Patient Education & Exercise," "Manual Therapy," and "Dry Needling & Taping," along with demonstrations of how each method is applied. Following the videos, data were collected on participants' treatment preferences and the reasons for their choices. At baseline, pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), pain-related beliefs using the Pain Beliefs Questionnaire (PBQ), depression levels using the Patient Health Questionnaire-9 (PHQ-9), and disability levels were evaluated using the Oswestry Disability Index (ODI) for low back pain and the Neck Disability Index (NDI) for neck pain. At the end of the treatment period, perceived changes in health status were measured using the Global Rating of Change (GRC) scale. All participants received Electrotherapy Modalities (TENS, ultrasound, and hot packs) for four weeks. At the 12th week, comparisons were made between participants who received their preferred treatment and those who did not, in terms of pain intensity, disability level, and perceived health status change. Data were analyzed using the SPSS statistical software; the Student's t-test was applied for parametric data, and the chi-square test was used for categorical data. A significance level of p<0.05 was considered statistically significant. The results showed that Electrotherapy Modalities were the most preferred treatment method among both low back and neck pain participants. Among participants with low back pain, 38% rated Electrotherapy Modalities as the most effective method, while 40% of those with neck pain did the same. While demographic characteristics, pain intensity, pain-related beliefs, depression levels, and disability scores did not significantly affect treatment preferences, a statistically significant relationship was found between previous treatment experiences and the preferred treatment method (p=0,001). While receiving a treatment consistent with one's preference did not have a significant effect on pain intensity, disability severity, or perceived health status, 71.8% (n=28) of the participants who received their preferred treatment, and 62.3% (n=28) of those who did not, reported an improvement in their condition compared to baseline. However, it was observed that previous treatment experiences and individual beliefs may influence the perceived effectiveness of the treatment method. Although the level of evidence in the literature regarding Electrotherapy Modalities is limited, their frequent selection by patients as the most effective treatment highlights the need for a more comprehensive and evidence-based patient education and information process regarding treatment options. While the findings indicate that treatment preferences do not have a direct impact on clinical outcomes, patient opinions and preferences remain important factors to consider in individualized treatment planning.