{ "abstract": "Background\n\nHealthcare utilization is high for people with spinal disorders. We aimed to investigate differences in recommended versus actual healthcare use among individuals with back & neck pain compared to individuals with isolated back or neck pain. Additionally, we aimed to examine variations in healthcare utilization patterns before and after a specialist evaluation based on the location of pain.Methods\n\nWe linked the Norwegian Neck and Back Registry with health registries, including patients with spinal disorders registered between January 1st, 2016, and December 31st, 2020 (9316 patients (63% with back pain, 27% with neck pain, 11% with back & neck pain) aged 18-70 years, mean (SD) age 44 (13) years, 57% females). We studied the percentages being recommended and actually visiting primary care physicians, physical therapists, and chiropractors in primary care and outpatient and inpatient consultations in specialist care after an outpatient specialist evaluation (index consultation), focusing on differences between groups based on the location of spinal pain.Results\n\nIn total, ~20%-80% followed healthcare recommendations. Patients with back & neck pain followed recommendations less often than patients with back pain (39% (95% CI 35.7, 41.8) vs 45% (95% CI 43.9, 46.4)) or neck pain (44% (95% CI 42.4, 46.3)). Participants with back & neck pain had a proportion of consultations with physical therapists at 29.7% (95% CI 25.1, 34.2) and 25.4% (95% CI 20.7, 30.1) in years 1 and 2 after index consultation, ~6 percentage points higher than the back pain group (1st: -5.8% (95% CI -10.6, -1.0), 2nd: -6.0% (95% CI -11.0, -0.9). They also had a 2 percentage point higher proportion of consultations with primary care physicians compared to the neck pain group (1st: -2.4% (95% CI -4.1, -0.8), 2nd: -1.5% (95% CI -2.7, -0.3)).Conclusions\n\nPatients with mixed back & neck pain have lower adherence to recommended care and higher utilization of physical therapy and primary care physicians two years after specialist evaluation compared to patients with isolated spinal pain. These results suggest that the current approach to managing spinal pain should be reconsidered to better address the complex needs of this patient group.", "abstract_shown": true, "affiliations": [ "Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway. lisegret@oslomet.no.", "Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.", "Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.", "Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.", "Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.", "Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.", "Chiropractic Knowledge Hub, Odense, Denmark.", "Cluster for Health Services Research, Norwegian Institute of Public Health, Oslo, Norway.", "Clinical Epidemiology Unit, Department of Clinical Sciences, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden." ], "article_type": "research article", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0 ], "name": "Lise Grethe Kjønø", "orcid": "0009-0005-4095-9667" }, { "affs": [ 1, 2 ], "name": "Kjersti Storheim" }, { "affs": [ 3 ], "name": "Kåre Rønn Richardsen" }, { "affs": [ 1 ], "name": "Bjørnar Berg" }, { "affs": [ 1, 4 ], "name": "Marianne Bakke Johnsen" }, { "affs": [ 5 ], "name": "Stine Haugaard Clausen" }, { "affs": [ 5, 6 ], "name": "Jan Hartvigsen" }, { "affs": [ 1, 2 ], "name": "Margreth Grotle" }, { "affs": [ 7, 8 ], "name": "Karin Magnusson" } ], "bibtex": "https://research.draconitic.com/paper/0avcw0gnm7b90.bib", "cited_by": 0, "doi": "10.1186/s12913-026-15256-w", "fulltext_url": "https://europepmc.org/articles/PMC13726017", "id": "0avcw0gnm7b90", "issns": [ "1472-6963" ], "landing_url": "https://europepmc.org/article/MED/42972327", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Research" ], [ "openalex", "2736|Musculoskeletal pain and rehabilitation" ] ], "openalex": "W7172294844", "pdf_url": "https://europepmc.org/articles/PMC13726017?pdf=render", "pmcid": "PMC13726017", "pmid": "42972327", "published": "2026-08-03", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/0avcw0gnm7b90.ris", "sources": [ { "first_seen": "2026-11-04T15:20:49Z", "native_id": "MED:42972327", "source": "europepmc", "url": "https://europepmc.org/article/MED/42972327" }, { "first_seen": "2026-11-05T12:22:26Z", "native_id": "PMC13726017", "source": "pmc", "url": "https://doi.org/10.1186/s12913-026-15256-w" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2736|Musculoskeletal pain and rehabilitation", "subfield": "pharmacology-toxicology" } ], "title": "Healthcare utilization in patients with spinal disorders referred for specialist evaluation in Norway: an observational register-based cohort study.", "title_text": "Healthcare utilization in patients with spinal disorders referred for specialist evaluation in Norway: an observational register-based cohort study.", "type": "peer-reviewed", "updated_at": "2026-11-06T12:22:04Z", "url": "https://research.draconitic.com/paper/0avcw0gnm7b90", "venue": "BMC health services research", "versions": [] }