Neck and back pain: Differences between patients treated in primary and specialist health care

Abstract

Objective: To describe and compare patients with neck and back pain treated by physiotherapists in primary healthcare (PHC) and in departments for physical medicine and rehabilitation in specialist healthcare (SHC) in Norway.Design: Cross-sectional study using data from the FYSIOPRIM database in PHC and the Norwegian Neck and Back Registry in SHC. Neck and back pain patients in the period 2014–18 aged ≥ 18 years were included. Demographics, lifestyle and clinical factors were investigated.Results: A total of 8,125 patients were included: 584 in PHC and 7,541 in SHC. Mean age was 47.1 and 45.5 years, respectively, with more females in PHC (72% vs 56%). Low levels of education and physical activity, high workload and receiving social benefits were associated with treatment in SHC. Treatment in SHC was most common from 3 to 12 months’ pain duration. Higher pain intensity and lower health-related quality of life were found in patients treated in SHC, no differences were found for psychological distress.Conclusion: This is the first study comparing register data in patients with neck and back pain treated in PHC and SHC. Differences were found in pain and health-related quality of life, but levels of psychological distress were similar between patients treated in PHC and those treated in SHC.