Objective: In various countries, patients can visit a physiotherapist via self-referral. The aims of this study were to evaluate whether there are differences between individuals with nonspecific neck pain who consult a manual therapist via self-referral and those who do so via referral by a physician concerning patient characteristics, number of treatments, and recovery; and whether (self-)referral is associated with recovery.

Methods: This study is part of a prospective cohort study with posttreatment and 12-month follow-up in a Dutch manual-therapy setting. Adult patients with nonspecific neck pain were eligible for participation. Baseline measurements included demographic data and data concerning neck pain. At follow-up, number of treatments, recovery, and satisfaction were assessed. To evaluate differences between the groups, we used the χ² test and the independent t test. A logistic regression analysis was used to evaluate the association between referral status and recovery.

Results: In total, 272 manual therapists participated and 1311 patients were included. Of 831 patients whose referral data are available, about half patients consulted a manual therapist by self-referral. The mean number of treatments was 5.4, which did not differ between the 2 groups. We found no differences between the groups concerning age, sex, pain intensity at baseline, or recovery rate. Patients in the self-referral group experienced acute neck pain more frequently, had recurrent complaints more often, and reported less disability compared to the referred group. Referral status was not associated with recovery.

Conclusion: We found several small differences between self-referred and referred patients.

Author keywords: Neck Pain; Referral and Consultation

Author affiliations: BJM: Institute for Master Education in Manual Therapy, SOMT University of Physiotherapy, Amersfoort, the Netherlands; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Physiotherapy, Avans University of Applied Sciences, Breda, the Netherlands; FJFJ: Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; BWK: Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark; APG: Institute for Master Education in Manual Therapy, SOMT University of Physiotherapy, Amersfoort, the Netherlands; Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; APV: Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia.

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