Managing Non-Specific Neck Pain by Healthcare Professionals in Qatar

Identifying the areas where evidence-based guidance is needed

Managing Non-Specific Neck Pain by Healthcare Professionals in Qatar: Identifying the areas where evidence-based guidance is needed

INTRODUCTION

Neck pain is a common condition and is a leading cause of disability worldwide. The estimated mean, annual and lifetime prevalence rates are 7.6%, 37.2% and 48.5%, respectively. Despite this, it attracts only a fraction of the research funding, and few clinical trials are dedicated solely to neck pain.

Simple (or non-specific) neck pain is the most common of neck pain and it denotes pain or discomfort in the neck and/or shoulder girdle with or without pain referred to the arms which cannot be attributed to a specific cause. The cause is usually multifactorial and includes poor posture, neck strain, sporting or occupational activities, anxiety, and depression. It usually goes away on its own within a few days or weeks. It may last longer or keep coming back in some people. Neck pain is “chronic” if it lasts more than 3 months.

The aim of this exploratory study is to identify areas of uncertainty that healthcare professionals in Qatar believe they need evidence-based recommendations to follow when managing non-specific neck pain.

By responding to this questionnaire, you agree to participate in this study.

Question Title

* A. General Demographics and Workload:

Speciality:

Age:

Years of experience in your speciality:

Nationality:

How many patients do you usually encounter per week?

How many patients with neck pain consult you per month?

Ho many of these patients with neck pain would come back for follow up visits?

What is the average consultation time (in minutes) you spend on dealing with a patient with neck pain?

Please rate the following statements from 1 to 10 based on the scale provided. You may add any useful comments or clarification that you think will help us in developing recommendations

Question Title

* B-1: When presenting with neck pain, it is:

	1 (Strongest Disagreement)	2	3	4	5	6	7	8	9	10 (strongest Agreement)	I Don't Know
Generally acute and self-limiting.	Generally acute and self-limiting. 1 (Strongest Disagreement)	Generally acute and self-limiting. 2	Generally acute and self-limiting. 3	Generally acute and self-limiting. 4	Generally acute and self-limiting. 5	Generally acute and self-limiting. 6	Generally acute and self-limiting. 7	Generally acute and self-limiting. 8	Generally acute and self-limiting. 9	Generally acute and self-limiting. 10 (strongest Agreement)	Generally acute and self-limiting. I Don't Know
Usually a secondary complaint (not the main reason for visiting the physician).	Usually a secondary complaint (not the main reason for visiting the physician). 1 (Strongest Disagreement)	Usually a secondary complaint (not the main reason for visiting the physician). 2	Usually a secondary complaint (not the main reason for visiting the physician). 3	Usually a secondary complaint (not the main reason for visiting the physician). 4	Usually a secondary complaint (not the main reason for visiting the physician). 5	Usually a secondary complaint (not the main reason for visiting the physician). 6	Usually a secondary complaint (not the main reason for visiting the physician). 7	Usually a secondary complaint (not the main reason for visiting the physician). 8	Usually a secondary complaint (not the main reason for visiting the physician). 9	Usually a secondary complaint (not the main reason for visiting the physician). 10 (strongest Agreement)	Usually a secondary complaint (not the main reason for visiting the physician). I Don't Know
Commonly associated with shoulder pain and/or headache.	Commonly associated with shoulder pain and/or headache. 1 (Strongest Disagreement)	Commonly associated with shoulder pain and/or headache. 2	Commonly associated with shoulder pain and/or headache. 3	Commonly associated with shoulder pain and/or headache. 4	Commonly associated with shoulder pain and/or headache. 5	Commonly associated with shoulder pain and/or headache. 6	Commonly associated with shoulder pain and/or headache. 7	Commonly associated with shoulder pain and/or headache. 8	Commonly associated with shoulder pain and/or headache. 9	Commonly associated with shoulder pain and/or headache. 10 (strongest Agreement)	Commonly associated with shoulder pain and/or headache. I Don't Know
Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both)	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 1 (Strongest Disagreement)	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 2	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 3	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 4	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 5	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 6	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 7	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 8	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 9	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) 10 (strongest Agreement)	Either purely nociceptive (mechanical) or neuropathic (with radicular pain). (not a mixture of both) I Don't Know

Please share your comments or further specify different answers/approach

Question Title

* B-2: You believe a patient should presenting with neck pain should URGENTLY be referred or admitted if the patient

	1 (Strongest Disagreement)	2	3	4	5	6	7	8	9	10 (strongest Agreement)	I Don't Know
Is over 50 years of age with cancer.	Is over 50 years of age with cancer. 1 (Strongest Disagreement)	Is over 50 years of age with cancer. 2	Is over 50 years of age with cancer. 3	Is over 50 years of age with cancer. 4	Is over 50 years of age with cancer. 5	Is over 50 years of age with cancer. 6	Is over 50 years of age with cancer. 7	Is over 50 years of age with cancer. 8	Is over 50 years of age with cancer. 9	Is over 50 years of age with cancer. 10 (strongest Agreement)	Is over 50 years of age with cancer. I Don't Know
Is over 50 years with vascular disease	Is over 50 years with vascular disease 1 (Strongest Disagreement)	Is over 50 years with vascular disease 2	Is over 50 years with vascular disease 3	Is over 50 years with vascular disease 4	Is over 50 years with vascular disease 5	Is over 50 years with vascular disease 6	Is over 50 years with vascular disease 7	Is over 50 years with vascular disease 8	Is over 50 years with vascular disease 9	Is over 50 years with vascular disease 10 (strongest Agreement)	Is over 50 years with vascular disease I Don't Know
Has fever	Has fever 1 (Strongest Disagreement)	Has fever 2	Has fever 3	Has fever 4	Has fever 5	Has fever 6	Has fever 7	Has fever 8	Has fever 9	Has fever 10 (strongest Agreement)	Has fever I Don't Know
Has neck stiffness	Has neck stiffness 1 (Strongest Disagreement)	Has neck stiffness 2	Has neck stiffness 3	Has neck stiffness 4	Has neck stiffness 5	Has neck stiffness 6	Has neck stiffness 7	Has neck stiffness 8	Has neck stiffness 9	Has neck stiffness 10 (strongest Agreement)	Has neck stiffness I Don't Know
Has nausea or vomiting	Has nausea or vomiting 1 (Strongest Disagreement)	Has nausea or vomiting 2	Has nausea or vomiting 3	Has nausea or vomiting 4	Has nausea or vomiting 5	Has nausea or vomiting 6	Has nausea or vomiting 7	Has nausea or vomiting 8	Has nausea or vomiting 9	Has nausea or vomiting 10 (strongest Agreement)	Has nausea or vomiting I Don't Know
Has unexplained weight loss	Has unexplained weight loss 1 (Strongest Disagreement)	Has unexplained weight loss 2	Has unexplained weight loss 3	Has unexplained weight loss 4	Has unexplained weight loss 5	Has unexplained weight loss 6	Has unexplained weight loss 7	Has unexplained weight loss 8	Has unexplained weight loss 9	Has unexplained weight loss 10 (strongest Agreement)	Has unexplained weight loss I Don't Know
Has torticollis	Has torticollis 1 (Strongest Disagreement)	Has torticollis 2	Has torticollis 3	Has torticollis 4	Has torticollis 5	Has torticollis 6	Has torticollis 7	Has torticollis 8	Has torticollis 9	Has torticollis 10 (strongest Agreement)	Has torticollis I Don't Know
Has limited neck mobility	Has limited neck mobility 1 (Strongest Disagreement)	Has limited neck mobility 2	Has limited neck mobility 3	Has limited neck mobility 4	Has limited neck mobility 5	Has limited neck mobility 6	Has limited neck mobility 7	Has limited neck mobility 8	Has limited neck mobility 9	Has limited neck mobility 10 (strongest Agreement)	Has limited neck mobility I Don't Know
Has erythema or exudate at the neck	Has erythema or exudate at the neck 1 (Strongest Disagreement)	Has erythema or exudate at the neck 2	Has erythema or exudate at the neck 3	Has erythema or exudate at the neck 4	Has erythema or exudate at the neck 5	Has erythema or exudate at the neck 6	Has erythema or exudate at the neck 7	Has erythema or exudate at the neck 8	Has erythema or exudate at the neck 9	Has erythema or exudate at the neck 10 (strongest Agreement)	Has erythema or exudate at the neck I Don't Know
Has severe neck tenderness	Has severe neck tenderness 1 (Strongest Disagreement)	Has severe neck tenderness 2	Has severe neck tenderness 3	Has severe neck tenderness 4	Has severe neck tenderness 5	Has severe neck tenderness 6	Has severe neck tenderness 7	Has severe neck tenderness 8	Has severe neck tenderness 9	Has severe neck tenderness 10 (strongest Agreement)	Has severe neck tenderness I Don't Know
Has high erythrocyte sedimentation rate (ESR)	Has high erythrocyte sedimentation rate (ESR) 1 (Strongest Disagreement)	Has high erythrocyte sedimentation rate (ESR) 2	Has high erythrocyte sedimentation rate (ESR) 3	Has high erythrocyte sedimentation rate (ESR) 4	Has high erythrocyte sedimentation rate (ESR) 5	Has high erythrocyte sedimentation rate (ESR) 6	Has high erythrocyte sedimentation rate (ESR) 7	Has high erythrocyte sedimentation rate (ESR) 8	Has high erythrocyte sedimentation rate (ESR) 9	Has high erythrocyte sedimentation rate (ESR) 10 (strongest Agreement)	Has high erythrocyte sedimentation rate (ESR) I Don't Know
Has high C reactive protein	Has high C reactive protein 1 (Strongest Disagreement)	Has high C reactive protein 2	Has high C reactive protein 3	Has high C reactive protein 4	Has high C reactive protein 5	Has high C reactive protein 6	Has high C reactive protein 7	Has high C reactive protein 8	Has high C reactive protein 9	Has high C reactive protein 10 (strongest Agreement)	Has high C reactive protein I Don't Know
Has raised white blood cell count	Has raised white blood cell count 1 (Strongest Disagreement)	Has raised white blood cell count 2	Has raised white blood cell count 3	Has raised white blood cell count 4	Has raised white blood cell count 5	Has raised white blood cell count 6	Has raised white blood cell count 7	Has raised white blood cell count 8	Has raised white blood cell count 9	Has raised white blood cell count 10 (strongest Agreement)	Has raised white blood cell count I Don't Know
Has trauma to the neck.	Has trauma to the neck. 1 (Strongest Disagreement)	Has trauma to the neck. 2	Has trauma to the neck. 3	Has trauma to the neck. 4	Has trauma to the neck. 5	Has trauma to the neck. 6	Has trauma to the neck. 7	Has trauma to the neck. 8	Has trauma to the neck. 9	Has trauma to the neck. 10 (strongest Agreement)	Has trauma to the neck. I Don't Know
Has incontinence	Has incontinence 1 (Strongest Disagreement)	Has incontinence 2	Has incontinence 3	Has incontinence 4	Has incontinence 5	Has incontinence 6	Has incontinence 7	Has incontinence 8	Has incontinence 9	Has incontinence 10 (strongest Agreement)	Has incontinence I Don't Know
Has altered cognitive status.	Has altered cognitive status. 1 (Strongest Disagreement)	Has altered cognitive status. 2	Has altered cognitive status. 3	Has altered cognitive status. 4	Has altered cognitive status. 5	Has altered cognitive status. 6	Has altered cognitive status. 7	Has altered cognitive status. 8	Has altered cognitive status. 9	Has altered cognitive status. 10 (strongest Agreement)	Has altered cognitive status. I Don't Know
Has ataxia	Has ataxia 1 (Strongest Disagreement)	Has ataxia 2	Has ataxia 3	Has ataxia 4	Has ataxia 5	Has ataxia 6	Has ataxia 7	Has ataxia 8	Has ataxia 9	Has ataxia 10 (strongest Agreement)	Has ataxia I Don't Know
Has visual loss	Has visual loss 1 (Strongest Disagreement)	Has visual loss 2	Has visual loss 3	Has visual loss 4	Has visual loss 5	Has visual loss 6	Has visual loss 7	Has visual loss 8	Has visual loss 9	Has visual loss 10 (strongest Agreement)	Has visual loss I Don't Know
Has new or severe headache	Has new or severe headache 1 (Strongest Disagreement)	Has new or severe headache 2	Has new or severe headache 3	Has new or severe headache 4	Has new or severe headache 5	Has new or severe headache 6	Has new or severe headache 7	Has new or severe headache 8	Has new or severe headache 9	Has new or severe headache 10 (strongest Agreement)	Has new or severe headache I Don't Know
Has photophobia or phonophobia	Has photophobia or phonophobia 1 (Strongest Disagreement)	Has photophobia or phonophobia 2	Has photophobia or phonophobia 3	Has photophobia or phonophobia 4	Has photophobia or phonophobia 5	Has photophobia or phonophobia 6	Has photophobia or phonophobia 7	Has photophobia or phonophobia 8	Has photophobia or phonophobia 9	Has photophobia or phonophobia 10 (strongest Agreement)	Has photophobia or phonophobia I Don't Know
Has signs of cervical myelopathy (upper motor neuron signs).	Has signs of cervical myelopathy (upper motor neuron signs). 1 (Strongest Disagreement)	Has signs of cervical myelopathy (upper motor neuron signs). 2	Has signs of cervical myelopathy (upper motor neuron signs). 3	Has signs of cervical myelopathy (upper motor neuron signs). 4	Has signs of cervical myelopathy (upper motor neuron signs). 5	Has signs of cervical myelopathy (upper motor neuron signs). 6	Has signs of cervical myelopathy (upper motor neuron signs). 7	Has signs of cervical myelopathy (upper motor neuron signs). 8	Has signs of cervical myelopathy (upper motor neuron signs). 9	Has signs of cervical myelopathy (upper motor neuron signs). 10 (strongest Agreement)	Has signs of cervical myelopathy (upper motor neuron signs). I Don't Know

Please share your comments or further specify different answers/approach

Question Title

* B-3 : In managing a patient with non-specific neck pain, how likely you would perform the following:

	1 (Not At All Likely)	2	3	4	5	6	7	8	9	10 (Extremely Likely)	I Don't Know
Provide reassurance if there are no red flags.	Provide reassurance if there are no red flags. 1 (Not At All Likely)	Provide reassurance if there are no red flags. 2	Provide reassurance if there are no red flags. 3	Provide reassurance if there are no red flags. 4	Provide reassurance if there are no red flags. 5	Provide reassurance if there are no red flags. 6	Provide reassurance if there are no red flags. 7	Provide reassurance if there are no red flags. 8	Provide reassurance if there are no red flags. 9	Provide reassurance if there are no red flags. 10 (Extremely Likely)	Provide reassurance if there are no red flags. I Don't Know
Advise the patient to remain active.	Advise the patient to remain active. 1 (Not At All Likely)	Advise the patient to remain active. 2	Advise the patient to remain active. 3	Advise the patient to remain active. 4	Advise the patient to remain active. 5	Advise the patient to remain active. 6	Advise the patient to remain active. 7	Advise the patient to remain active. 8	Advise the patient to remain active. 9	Advise the patient to remain active. 10 (Extremely Likely)	Advise the patient to remain active. I Don't Know
Advise the patient to have bed rest	Advise the patient to have bed rest 1 (Not At All Likely)	Advise the patient to have bed rest 2	Advise the patient to have bed rest 3	Advise the patient to have bed rest 4	Advise the patient to have bed rest 5	Advise the patient to have bed rest 6	Advise the patient to have bed rest 7	Advise the patient to have bed rest 8	Advise the patient to have bed rest 9	Advise the patient to have bed rest 10 (Extremely Likely)	Advise the patient to have bed rest I Don't Know
Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 1 (Not At All Likely)	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 2	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 3	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 4	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 5	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 6	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 7	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 8	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 9	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm 10 (Extremely Likely)	Advise the patient to avoid movement/activity that provokes radiating pain or other symptoms in the arm I Don't Know
Advise the patient to continue/return to work	Advise the patient to continue/return to work 1 (Not At All Likely)	Advise the patient to continue/return to work 2	Advise the patient to continue/return to work 3	Advise the patient to continue/return to work 4	Advise the patient to continue/return to work 5	Advise the patient to continue/return to work 6	Advise the patient to continue/return to work 7	Advise the patient to continue/return to work 8	Advise the patient to continue/return to work 9	Advise the patient to continue/return to work 10 (Extremely Likely)	Advise the patient to continue/return to work I Don't Know
Provide the patient with work-related/occupational/postural advice	Provide the patient with work-related/occupational/postural advice 1 (Not At All Likely)	Provide the patient with work-related/occupational/postural advice 2	Provide the patient with work-related/occupational/postural advice 3	Provide the patient with work-related/occupational/postural advice 4	Provide the patient with work-related/occupational/postural advice 5	Provide the patient with work-related/occupational/postural advice 6	Provide the patient with work-related/occupational/postural advice 7	Provide the patient with work-related/occupational/postural advice 8	Provide the patient with work-related/occupational/postural advice 9	Provide the patient with work-related/occupational/postural advice 10 (Extremely Likely)	Provide the patient with work-related/occupational/postural advice I Don't Know
Assess the psychosocial aspects that delay/inhibit recovery	Assess the psychosocial aspects that delay/inhibit recovery 1 (Not At All Likely)	Assess the psychosocial aspects that delay/inhibit recovery 2	Assess the psychosocial aspects that delay/inhibit recovery 3	Assess the psychosocial aspects that delay/inhibit recovery 4	Assess the psychosocial aspects that delay/inhibit recovery 5	Assess the psychosocial aspects that delay/inhibit recovery 6	Assess the psychosocial aspects that delay/inhibit recovery 7	Assess the psychosocial aspects that delay/inhibit recovery 8	Assess the psychosocial aspects that delay/inhibit recovery 9	Assess the psychosocial aspects that delay/inhibit recovery 10 (Extremely Likely)	Assess the psychosocial aspects that delay/inhibit recovery I Don't Know
Order an x-ray of the neck	Order an x-ray of the neck 1 (Not At All Likely)	Order an x-ray of the neck 2	Order an x-ray of the neck 3	Order an x-ray of the neck 4	Order an x-ray of the neck 5	Order an x-ray of the neck 6	Order an x-ray of the neck 7	Order an x-ray of the neck 8	Order an x-ray of the neck 9	Order an x-ray of the neck 10 (Extremely Likely)	Order an x-ray of the neck I Don't Know
Order MRI of cervical spine	Order MRI of cervical spine 1 (Not At All Likely)	Order MRI of cervical spine 2	Order MRI of cervical spine 3	Order MRI of cervical spine 4	Order MRI of cervical spine 5	Order MRI of cervical spine 6	Order MRI of cervical spine 7	Order MRI of cervical spine 8	Order MRI of cervical spine 9	Order MRI of cervical spine 10 (Extremely Likely)	Order MRI of cervical spine I Don't Know
Order CT scan of cervical spine	Order CT scan of cervical spine 1 (Not At All Likely)	Order CT scan of cervical spine 2	Order CT scan of cervical spine 3	Order CT scan of cervical spine 4	Order CT scan of cervical spine 5	Order CT scan of cervical spine 6	Order CT scan of cervical spine 7	Order CT scan of cervical spine 8	Order CT scan of cervical spine 9	Order CT scan of cervical spine 10 (Extremely Likely)	Order CT scan of cervical spine I Don't Know
Refer to electromyography	Refer to electromyography 1 (Not At All Likely)	Refer to electromyography 2	Refer to electromyography 3	Refer to electromyography 4	Refer to electromyography 5	Refer to electromyography 6	Refer to electromyography 7	Refer to electromyography 8	Refer to electromyography 9	Refer to electromyography 10 (Extremely Likely)	Refer to electromyography I Don't Know
Prescribe paracetamol	Prescribe paracetamol 1 (Not At All Likely)	Prescribe paracetamol 2	Prescribe paracetamol 3	Prescribe paracetamol 4	Prescribe paracetamol 5	Prescribe paracetamol 6	Prescribe paracetamol 7	Prescribe paracetamol 8	Prescribe paracetamol 9	Prescribe paracetamol 10 (Extremely Likely)	Prescribe paracetamol I Don't Know
Prescribe NSAIDs	Prescribe NSAIDs 1 (Not At All Likely)	Prescribe NSAIDs 2	Prescribe NSAIDs 3	Prescribe NSAIDs 4	Prescribe NSAIDs 5	Prescribe NSAIDs 6	Prescribe NSAIDs 7	Prescribe NSAIDs 8	Prescribe NSAIDs 9	Prescribe NSAIDs 10 (Extremely Likely)	Prescribe NSAIDs I Don't Know
Prescribe analgesics only if accompanied by neuropathic pain	Prescribe analgesics only if accompanied by neuropathic pain 1 (Not At All Likely)	Prescribe analgesics only if accompanied by neuropathic pain 2	Prescribe analgesics only if accompanied by neuropathic pain 3	Prescribe analgesics only if accompanied by neuropathic pain 4	Prescribe analgesics only if accompanied by neuropathic pain 5	Prescribe analgesics only if accompanied by neuropathic pain 6	Prescribe analgesics only if accompanied by neuropathic pain 7	Prescribe analgesics only if accompanied by neuropathic pain 8	Prescribe analgesics only if accompanied by neuropathic pain 9	Prescribe analgesics only if accompanied by neuropathic pain 10 (Extremely Likely)	Prescribe analgesics only if accompanied by neuropathic pain I Don't Know
Prescribe opioids including tramadol	Prescribe opioids including tramadol 1 (Not At All Likely)	Prescribe opioids including tramadol 2	Prescribe opioids including tramadol 3	Prescribe opioids including tramadol 4	Prescribe opioids including tramadol 5	Prescribe opioids including tramadol 6	Prescribe opioids including tramadol 7	Prescribe opioids including tramadol 8	Prescribe opioids including tramadol 9	Prescribe opioids including tramadol 10 (Extremely Likely)	Prescribe opioids including tramadol I Don't Know
Prescribe oral steroids	Prescribe oral steroids 1 (Not At All Likely)	Prescribe oral steroids 2	Prescribe oral steroids 3	Prescribe oral steroids 4	Prescribe oral steroids 5	Prescribe oral steroids 6	Prescribe oral steroids 7	Prescribe oral steroids 8	Prescribe oral steroids 9	Prescribe oral steroids 10 (Extremely Likely)	Prescribe oral steroids I Don't Know
Prescribe topical medications including NSAIDs	Prescribe topical medications including NSAIDs 1 (Not At All Likely)	Prescribe topical medications including NSAIDs 2	Prescribe topical medications including NSAIDs 3	Prescribe topical medications including NSAIDs 4	Prescribe topical medications including NSAIDs 5	Prescribe topical medications including NSAIDs 6	Prescribe topical medications including NSAIDs 7	Prescribe topical medications including NSAIDs 8	Prescribe topical medications including NSAIDs 9	Prescribe topical medications including NSAIDs 10 (Extremely Likely)	Prescribe topical medications including NSAIDs I Don't Know
Prescribe Spinal epidural steroid injection with severe persistent symptoms	Prescribe Spinal epidural steroid injection with severe persistent symptoms 1 (Not At All Likely)	Prescribe Spinal epidural steroid injection with severe persistent symptoms 2	Prescribe Spinal epidural steroid injection with severe persistent symptoms 3	Prescribe Spinal epidural steroid injection with severe persistent symptoms 4	Prescribe Spinal epidural steroid injection with severe persistent symptoms 5	Prescribe Spinal epidural steroid injection with severe persistent symptoms 6	Prescribe Spinal epidural steroid injection with severe persistent symptoms 7	Prescribe Spinal epidural steroid injection with severe persistent symptoms 8	Prescribe Spinal epidural steroid injection with severe persistent symptoms 9	Prescribe Spinal epidural steroid injection with severe persistent symptoms 10 (Extremely Likely)	Prescribe Spinal epidural steroid injection with severe persistent symptoms I Don't Know
Offer sick leave	Offer sick leave 1 (Not At All Likely)	Offer sick leave 2	Offer sick leave 3	Offer sick leave 4	Offer sick leave 5	Offer sick leave 6	Offer sick leave 7	Offer sick leave 8	Offer sick leave 9	Offer sick leave 10 (Extremely Likely)	Offer sick leave I Don't Know
Schedule a follow-up visit	Schedule a follow-up visit 1 (Not At All Likely)	Schedule a follow-up visit 2	Schedule a follow-up visit 3	Schedule a follow-up visit 4	Schedule a follow-up visit 5	Schedule a follow-up visit 6	Schedule a follow-up visit 7	Schedule a follow-up visit 8	Schedule a follow-up visit 9	Schedule a follow-up visit 10 (Extremely Likely)	Schedule a follow-up visit I Don't Know

Please share your comments or further specify different answers/approach

Question Title

* B-4: The following modalities are helpful in managing patients with neck pain:

	1 (Strongest Disagreement)	2	3	4	5	6	7	8	9	10 (strongest Agreement)	I Don't Know
Thermotherapy including hot/ cold compress, bath, sauna	Thermotherapy including hot/ cold compress, bath, sauna 1 (Strongest Disagreement)	Thermotherapy including hot/ cold compress, bath, sauna 2	Thermotherapy including hot/ cold compress, bath, sauna 3	Thermotherapy including hot/ cold compress, bath, sauna 4	Thermotherapy including hot/ cold compress, bath, sauna 5	Thermotherapy including hot/ cold compress, bath, sauna 6	Thermotherapy including hot/ cold compress, bath, sauna 7	Thermotherapy including hot/ cold compress, bath, sauna 8	Thermotherapy including hot/ cold compress, bath, sauna 9	Thermotherapy including hot/ cold compress, bath, sauna 10 (strongest Agreement)	Thermotherapy including hot/ cold compress, bath, sauna I Don't Know
Manual therapy including mobilisation, manipulation and soft-tissue techniques	Manual therapy including mobilisation, manipulation and soft-tissue techniques 1 (Strongest Disagreement)	Manual therapy including mobilisation, manipulation and soft-tissue techniques 2	Manual therapy including mobilisation, manipulation and soft-tissue techniques 3	Manual therapy including mobilisation, manipulation and soft-tissue techniques 4	Manual therapy including mobilisation, manipulation and soft-tissue techniques 5	Manual therapy including mobilisation, manipulation and soft-tissue techniques 6	Manual therapy including mobilisation, manipulation and soft-tissue techniques 7	Manual therapy including mobilisation, manipulation and soft-tissue techniques 8	Manual therapy including mobilisation, manipulation and soft-tissue techniques 9	Manual therapy including mobilisation, manipulation and soft-tissue techniques 10 (strongest Agreement)	Manual therapy including mobilisation, manipulation and soft-tissue techniques I Don't Know
Exercise programs/therapy	Exercise programs/therapy 1 (Strongest Disagreement)	Exercise programs/therapy 2	Exercise programs/therapy 3	Exercise programs/therapy 4	Exercise programs/therapy 5	Exercise programs/therapy 6	Exercise programs/therapy 7	Exercise programs/therapy 8	Exercise programs/therapy 9	Exercise programs/therapy 10 (strongest Agreement)	Exercise programs/therapy I Don't Know
Postural re-education	Postural re-education 1 (Strongest Disagreement)	Postural re-education 2	Postural re-education 3	Postural re-education 4	Postural re-education 5	Postural re-education 6	Postural re-education 7	Postural re-education 8	Postural re-education 9	Postural re-education 10 (strongest Agreement)	Postural re-education I Don't Know
Traction	Traction 1 (Strongest Disagreement)	Traction 2	Traction 3	Traction 4	Traction 5	Traction 6	Traction 7	Traction 8	Traction 9	Traction 10 (strongest Agreement)	Traction I Don't Know
Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 1 (Strongest Disagreement)	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 2	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 3	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 4	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 5	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 6	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 7	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 8	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 9	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic 10 (strongest Agreement)	Electrotherapy including light, laser, Low Level Laser Therapy (LLLT), pulsed electromagnetic, TENS, Ultrasound (US), shockwave, Magnetic, electromagnetic I Don't Know
Cervical orthoses (soft and stiff neck collars)	Cervical orthoses (soft and stiff neck collars) 1 (Strongest Disagreement)	Cervical orthoses (soft and stiff neck collars) 2	Cervical orthoses (soft and stiff neck collars) 3	Cervical orthoses (soft and stiff neck collars) 4	Cervical orthoses (soft and stiff neck collars) 5	Cervical orthoses (soft and stiff neck collars) 6	Cervical orthoses (soft and stiff neck collars) 7	Cervical orthoses (soft and stiff neck collars) 8	Cervical orthoses (soft and stiff neck collars) 9	Cervical orthoses (soft and stiff neck collars) 10 (strongest Agreement)	Cervical orthoses (soft and stiff neck collars) I Don't Know
Cervical cushion (as the one used in long flights)	Cervical cushion (as the one used in long flights) 1 (Strongest Disagreement)	Cervical cushion (as the one used in long flights) 2	Cervical cushion (as the one used in long flights) 3	Cervical cushion (as the one used in long flights) 4	Cervical cushion (as the one used in long flights) 5	Cervical cushion (as the one used in long flights) 6	Cervical cushion (as the one used in long flights) 7	Cervical cushion (as the one used in long flights) 8	Cervical cushion (as the one used in long flights) 9	Cervical cushion (as the one used in long flights) 10 (strongest Agreement)	Cervical cushion (as the one used in long flights) I Don't Know
Acupuncture/dry needling	Acupuncture/dry needling 1 (Strongest Disagreement)	Acupuncture/dry needling 2	Acupuncture/dry needling 3	Acupuncture/dry needling 4	Acupuncture/dry needling 5	Acupuncture/dry needling 6	Acupuncture/dry needling 7	Acupuncture/dry needling 8	Acupuncture/dry needling 9	Acupuncture/dry needling 10 (strongest Agreement)	Acupuncture/dry needling I Don't Know
Kinesiology taping and strapping	Kinesiology taping and strapping 1 (Strongest Disagreement)	Kinesiology taping and strapping 2	Kinesiology taping and strapping 3	Kinesiology taping and strapping 4	Kinesiology taping and strapping 5	Kinesiology taping and strapping 6	Kinesiology taping and strapping 7	Kinesiology taping and strapping 8	Kinesiology taping and strapping 9	Kinesiology taping and strapping 10 (strongest Agreement)	Kinesiology taping and strapping I Don't Know
Psychological therapies incl. behavioural and cognitive-behavioural therapies	Psychological therapies incl. behavioural and cognitive-behavioural therapies 1 (Strongest Disagreement)	Psychological therapies incl. behavioural and cognitive-behavioural therapies 2	Psychological therapies incl. behavioural and cognitive-behavioural therapies 3	Psychological therapies incl. behavioural and cognitive-behavioural therapies 4	Psychological therapies incl. behavioural and cognitive-behavioural therapies 5	Psychological therapies incl. behavioural and cognitive-behavioural therapies 6	Psychological therapies incl. behavioural and cognitive-behavioural therapies 7	Psychological therapies incl. behavioural and cognitive-behavioural therapies 8	Psychological therapies incl. behavioural and cognitive-behavioural therapies 9	Psychological therapies incl. behavioural and cognitive-behavioural therapies 10 (strongest Agreement)	Psychological therapies incl. behavioural and cognitive-behavioural therapies I Don't Know
Multidisciplinary treatment/programs	Multidisciplinary treatment/programs 1 (Strongest Disagreement)	Multidisciplinary treatment/programs 2	Multidisciplinary treatment/programs 3	Multidisciplinary treatment/programs 4	Multidisciplinary treatment/programs 5	Multidisciplinary treatment/programs 6	Multidisciplinary treatment/programs 7	Multidisciplinary treatment/programs 8	Multidisciplinary treatment/programs 9	Multidisciplinary treatment/programs 10 (strongest Agreement)	Multidisciplinary treatment/programs I Don't Know

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* B-5: How useful to you are the following imaging methods in managing a patient with neck pain?

	1 (Not At All Useful)	2	3	4	5	6	7	8	9	10 (Very Useful)	I Don't Know
X-ray of the neck	X-ray of the neck 1 (Not At All Useful)	X-ray of the neck 2	X-ray of the neck 3	X-ray of the neck 4	X-ray of the neck 5	X-ray of the neck 6	X-ray of the neck 7	X-ray of the neck 8	X-ray of the neck 9	X-ray of the neck 10 (Very Useful)	X-ray of the neck I Don't Know
MRI of cervical spine	MRI of cervical spine 1 (Not At All Useful)	MRI of cervical spine 2	MRI of cervical spine 3	MRI of cervical spine 4	MRI of cervical spine 5	MRI of cervical spine 6	MRI of cervical spine 7	MRI of cervical spine 8	MRI of cervical spine 9	MRI of cervical spine 10 (Very Useful)	MRI of cervical spine I Don't Know
CT scan of cervical spine	CT scan of cervical spine 1 (Not At All Useful)	CT scan of cervical spine 2	CT scan of cervical spine 3	CT scan of cervical spine 4	CT scan of cervical spine 5	CT scan of cervical spine 6	CT scan of cervical spine 7	CT scan of cervical spine 8	CT scan of cervical spine 9	CT scan of cervical spine 10 (Very Useful)	CT scan of cervical spine I Don't Know
Other imaging techniques (select 1 if there is none, or explain in the box below)	Other imaging techniques (select 1 if there is none, or explain in the box below) 1 (Not At All Useful)	Other imaging techniques (select 1 if there is none, or explain in the box below) 2	Other imaging techniques (select 1 if there is none, or explain in the box below) 3	Other imaging techniques (select 1 if there is none, or explain in the box below) 4	Other imaging techniques (select 1 if there is none, or explain in the box below) 5	Other imaging techniques (select 1 if there is none, or explain in the box below) 6	Other imaging techniques (select 1 if there is none, or explain in the box below) 7	Other imaging techniques (select 1 if there is none, or explain in the box below) 8	Other imaging techniques (select 1 if there is none, or explain in the box below) 9	Other imaging techniques (select 1 if there is none, or explain in the box below) 10 (Very Useful)	Other imaging techniques (select 1 if there is none, or explain in the box below) I Don't Know

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* B-6: How often do you refer a patient with neck pain to the following specialists?

	1 (Not At All Likely)	2	3	4	5	6	7	8	9	10 (Extremely Likely)	I Don't Know
Physical therapist	Physical therapist 1 (Not At All Likely)	Physical therapist 2	Physical therapist 3	Physical therapist 4	Physical therapist 5	Physical therapist 6	Physical therapist 7	Physical therapist 8	Physical therapist 9	Physical therapist 10 (Extremely Likely)	Physical therapist I Don't Know
Occupational health officer	Occupational health officer 1 (Not At All Likely)	Occupational health officer 2	Occupational health officer 3	Occupational health officer 4	Occupational health officer 5	Occupational health officer 6	Occupational health officer 7	Occupational health officer 8	Occupational health officer 9	Occupational health officer 10 (Extremely Likely)	Occupational health officer I Don't Know
Psychologist/psychiatrist	Psychologist/psychiatrist 1 (Not At All Likely)	Psychologist/psychiatrist 2	Psychologist/psychiatrist 3	Psychologist/psychiatrist 4	Psychologist/psychiatrist 5	Psychologist/psychiatrist 6	Psychologist/psychiatrist 7	Psychologist/psychiatrist 8	Psychologist/psychiatrist 9	Psychologist/psychiatrist 10 (Extremely Likely)	Psychologist/psychiatrist I Don't Know
Orthopedic Surgeon	Orthopedic Surgeon 1 (Not At All Likely)	Orthopedic Surgeon 2	Orthopedic Surgeon 3	Orthopedic Surgeon 4	Orthopedic Surgeon 5	Orthopedic Surgeon 6	Orthopedic Surgeon 7	Orthopedic Surgeon 8	Orthopedic Surgeon 9	Orthopedic Surgeon 10 (Extremely Likely)	Orthopedic Surgeon I Don't Know
Neurologist.	Neurologist. 1 (Not At All Likely)	Neurologist. 2	Neurologist. 3	Neurologist. 4	Neurologist. 5	Neurologist. 6	Neurologist. 7	Neurologist. 8	Neurologist. 9	Neurologist. 10 (Extremely Likely)	Neurologist. I Don't Know
Pain management clinic.	Pain management clinic. 1 (Not At All Likely)	Pain management clinic. 2	Pain management clinic. 3	Pain management clinic. 4	Pain management clinic. 5	Pain management clinic. 6	Pain management clinic. 7	Pain management clinic. 8	Pain management clinic. 9	Pain management clinic. 10 (Extremely Likely)	Pain management clinic. I Don't Know

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* B-7: When managing patients with neck pain, how important to you are the following outcome?

	1 (Not At All Important)	2	3	4	5	6	7	8	9	10 (Extremely Important)	I Don't Know
Relief of symptom	Relief of symptom 1 (Not At All Important)	Relief of symptom 2	Relief of symptom 3	Relief of symptom 4	Relief of symptom 5	Relief of symptom 6	Relief of symptom 7	Relief of symptom 8	Relief of symptom 9	Relief of symptom 10 (Extremely Important)	Relief of symptom I Don't Know
Preserving neck and arm mobility	Preserving neck and arm mobility 1 (Not At All Important)	Preserving neck and arm mobility 2	Preserving neck and arm mobility 3	Preserving neck and arm mobility 4	Preserving neck and arm mobility 5	Preserving neck and arm mobility 6	Preserving neck and arm mobility 7	Preserving neck and arm mobility 8	Preserving neck and arm mobility 9	Preserving neck and arm mobility 10 (Extremely Important)	Preserving neck and arm mobility I Don't Know
Prevention of recurrence	Prevention of recurrence 1 (Not At All Important)	Prevention of recurrence 2	Prevention of recurrence 3	Prevention of recurrence 4	Prevention of recurrence 5	Prevention of recurrence 6	Prevention of recurrence 7	Prevention of recurrence 8	Prevention of recurrence 9	Prevention of recurrence 10 (Extremely Important)	Prevention of recurrence I Don't Know
Prevention of complications	Prevention of complications 1 (Not At All Important)	Prevention of complications 2	Prevention of complications 3	Prevention of complications 4	Prevention of complications 5	Prevention of complications 6	Prevention of complications 7	Prevention of complications 8	Prevention of complications 9	Prevention of complications 10 (Extremely Important)	Prevention of complications I Don't Know
Not causing harm to the patient	Not causing harm to the patient 1 (Not At All Important)	Not causing harm to the patient 2	Not causing harm to the patient 3	Not causing harm to the patient 4	Not causing harm to the patient 5	Not causing harm to the patient 6	Not causing harm to the patient 7	Not causing harm to the patient 8	Not causing harm to the patient 9	Not causing harm to the patient 10 (Extremely Important)	Not causing harm to the patient I Don't Know
Patient satisfaction	Patient satisfaction 1 (Not At All Important)	Patient satisfaction 2	Patient satisfaction 3	Patient satisfaction 4	Patient satisfaction 5	Patient satisfaction 6	Patient satisfaction 7	Patient satisfaction 8	Patient satisfaction 9	Patient satisfaction 10 (Extremely Important)	Patient satisfaction I Don't Know
Other outcomes	Other outcomes 1 (Not At All Important)	Other outcomes 2	Other outcomes 3	Other outcomes 4	Other outcomes 5	Other outcomes 6	Other outcomes 7	Other outcomes 8	Other outcomes 9	Other outcomes 10 (Extremely Important)	Other outcomes I Don't Know

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