title: Patterns and perceptions of care for treatment of back and neck pain: results of a national survey.
abstract: METHODS
  We conducted a nationally representative random household telephone survey to assess therapies used to treat back or neck pain.
  
  
  OBJECTIVE
  The main outcome was complementary therapies used in the last year to treat back or neck pain.
  
  
  BACKGROUND
  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.
authors.affiliation: Center for Alternative Medicine Research and Education, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Department of Medicine, Boston, MA, USA. pwolsko@caregroup.harvard.edu
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wolsko
authors.forename: David M
authors.initials: DM
authors.lastname: Eisenberg
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.forename: Ronald
authors.initials: R
authors.lastname: Kessler
authors.forename: Russell S
authors.initials: RS
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology / Q000628:therapy*; D002684:Chiropractic / Q000706:statistics & numerical data; D000529:Complementary Therapies / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008405:Massage / Q000706:statistics & numerical data; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012064:Relaxation Therapy / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology