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Patterns and Perceptions of Care for Treatment of Back and Neck Pain: Results of a National Survey

Wolsko, Peter M. MD, MPH*; Eisenberg, David M. MD*; Davis, Roger B. ScD*; Kessler, Ronald PhD† and; Phillips, Russell S. MD*

Health Services Research

Study Design. We conducted a nationally representative random household telephone survey to assess therapies used to treat back or neck pain.

Objectives. The main outcome was complementary therapies used in the last year to treat back or neck pain.

Summary of Background Data. Back pain and neck pain are common medical conditions that cause substantial morbidity. Despite the presumed importance of complementary therapies for these conditions, studies of care for back and neck pain have not gathered information about the use of complementary therapies.

Methods. Our nationally representative survey sampled 2055 adults. The survey gathered detailed information about medical conditions, conventional and complementary therapies used to treat those conditions, and the perceived helpfulness of those therapies.

Results. We found that of those reporting back or neck pain in the last 12 months, 37% had seen a conventional provider and 54% had used complementary therapies to treat their condition. Chiropractic, massage, and relaxation techniques were the most commonly used complementary treatments for back or neck pain (20%, 14%, and 12%, respectively, of those with back or neck pain). Chiropractic, massage, and relaxation techniques were rated as “very helpful” for back or neck pain among users (61%, 65%, and 43%, respectively), whereas conventional providers were rated as “very helpful” by 27% of users. We estimate that nearly one-third of all complementary provider visits in 1997 (203 million of 629 million) were made specifically for the treatment of back or neck pain.

Conclusions. Chiropractic, massage, relaxation techniques, and other complementary methods all play an important role in the care of patients with back or neck pain. Treatment for back and neck pain was responsible for a large proportion of all complementary provider visits made in 1997. The frequent use and perceived helpfulness of commonly used complementary methods for these conditions warrant further investigation.

From the *Center for Alternative Medicine Research and Education, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Department of Medicine, Boston,

and the †Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

This project was supported by National Institutes of Health grant U24 AR43441, Bethesda, MD; the John E. Fetzer Institute, Kalamazoo, MI; the American Society of Actuaries, Schaumburg, IL; the Friends of Beth Israel Deaconess Medical Center and the Kenneth J. Germeshausen Foundation, Boston, MA; and the J.E. and Z.B. Butler Foundation, New York, NY. Dr. Wolsko was supported by an Institutional National Research Service Award for Training in Alternative Medicine Research (T32 AT00051), National Institutes of Health, Bethesda, MD; Dr. Phillips was supported by a Mid-Career Investigator Award (K24 AT00589) from the National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, MD.

Acknowledgment date: January 7, 2002.

First revision date: April 5, 2002. Second revision date: June 10, 2002.

Acceptance date: June 17, 2002.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Federal, foundation, and professional organization funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Peter M. Wolsko, MD, MPH, Harvard Osher Institute, 22A Landmark Center 2-West, 401 Park Drive, Boston, MA 02215; E-Mail: pwolsko@caregroup.harvard.edu

© 2003 Lippincott Williams & Wilkins, Inc.