The treatment of neck and low back pain - Who seeks care? Who goes where?

BACKGROUND. Neck and low back pain are leading causes of morbidity and heal th care utilization. However, little is known about the characteristics tha t differentiate those who seek from those who do not seek health care for t heir pain. OBJECTIVES. The objectives of this study were to: 1) describe health care u tilization for neck and back pain; 2) determine the characteristics of indi viduals seeking health care for neck and back pain; and 3) identify the cha racteristics of patients who consult medical doctors, chiropractors, or bot h. DESIGN. Population-based cross-sectional mailed survey. SUBJECTS. Subjects were randomly selected adults from the Saskatchewan Heal th Insurance and Registration File. MEASURES. Demographic, socio-economic, general health, comorbidity, health- related-quality-of-life, pain severity and health care utilization data wer e collected. The main outcome was whether subjects with prevalent neck or l ow back pain visited a health care provider in the previous month. RESULTS. Twenty-five percent of individuals with neck or low back pain visi ted a health care provider. Seeking health care was associated with disabli ng neck or back pain, digestive disorders, worse bodily pain and worse phys ical-role-functioning. Compared with medical patients, fewer chiropractic p atients lived in rural areas or reported arthritis, but they reported bette r social and physical functioning. More patients consulting both providers reported disabling neck or back pain. CONCLUSIONS. Individuals seeking care for neck or back pain have worse heal th status than those who do not seek care. Patients consulting chiropractor s alone report fewer comorbidities and are less limited in their activities than those consulting medical doctors.