Management of back and neck pain: who seeks care from physical therapists?
OBJECTIVE
Little information is available on factors associated with physical therapist use by people with back or neck pain. Identifying the characteristics of people who seek care from physical therapists is a useful first step in determining whether there is appropriate use of physical therapy services. The purpose of this study was to identify factors associated with physical therapist use by people with back or neck pain.


METHODS
The subjects were 29,049 people who had back pain or neck pain, or both, and who were seen for an initial evaluation at 1 of 21 US spine care centers. Each subject and evaluating physician completed a written survey at the time of the initial evaluation.


METHODS
Multiple logistic regression analyses were conducted to identify factors associated with physical therapist use.


RESULTS
Several measures of health and illness severity were associated with physical therapist use. Age and being male were negatively associated with physical therapist use. Education level, having workers' compensation coverage, and being in litigation were positively associated with physical therapist use. Physical therapist use also varied by previous physician use and census region.


CONCLUSIONS
The results suggest that variations in physical therapist use are associated with factors other than health and illness severity. The results also suggest that people who would benefit from physical therapy may not be receiving it or that people who would not benefit from physical therapy are receiving it, or both.
Freburger
Janet K
JK
Center for Health Services Research, University of North Carolina, 725 Airport Rd, CB#7590, Chapel Hill, NC 27599-7590, USA. janet_freburger@unc.edu
Carey
Timothy S
TS
Holmes
George M
GM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001416:Back Pain / Q000534:rehabilitation*; D035881:Compensation and Redress; D019992:Databases as Topic; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012737:Sex Factors; D013122:Spinal Diseases / Q000150:complications / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014481:United States; D014942:Workers' Compensation / Q000706:statistics & numerical data