Chiropractic patients in the Netherlands: A descriptive study

Background: Despite the worldwide popularity of chiropractic, there is stil l relatively little known about the patients who visit chiropractors in the Netherlands and other European countries. Objective: To describe in-depth the patient population of new patients to c hiropractors in the Netherlands. Design: Study population consisted of 10 consecutive new patients per parti cipating chiropractor. A retrospective-type questionnaire was used. Setting: Private practice. Outcome measures: Mode of referral, area, and nature of the complaints: rel ated to the chief complaint: previous treatments, examinations, type of ref erral, days lost at work, level of pain, and treatment expectations. Results: Of the 130 chiropractors registered with the Netherlands Chiroprac tors' Association, 93 chiropractors (78%) participated. Eight hundred thirt y-three patients (89%) returned questionnaires. By far, the greatest reason that patients visit chiropractors in the Netherlands is for neuromusculosk eletal (NMS) complaints. At the time of examination, 86% of the patients ha d spinal-related complaints, of which 12% involved multiple areas of the sp ine. Non-NMS complaints an minimal (< 2%). Seventy-seven percent of patient s with NMS complaints have chronic complaints (>12 weeks). Three-quarters o f these patients have undergone previous conservative therapy for their com plaint, which includes physical and manual therapy, postural correction, an d exercise therapy. Despite the chronic nature of their complaints, patient s have high expectations that their treatment will be effective. Conclusions: Most patients who see chiropractors in the Netherlands have ch ronic NMS-related complaints. Chiropractors are not a part of the normal re ferral system in this country, with the result that the patients have rathe r lung histories, including previous evaluations by medical specialists and other pl previous forms of (conservative) care.