- •Willingness to pay for a 1-point reduction in chronic back pain was $45.98 per month.
- •Willingness to pay for a 1-point reduction in chronic neck pain was $37.32 per month.
- •These estimates met a variety of validity checks including downward-sloping demand.
- •Patients reported that their pain would be higher without chiropractic visits.
- •Comparing stated WTP with visit costs indicates patients pay to avoid this higher pain.
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- Comparing CESD-10, PHQ-9, and PROMIS depression instruments in individuals with multiple sclerosis.Rehabil Psychol. 2014; 59: 220
- Can hypothetical questions reveal true values? A laboratory comparison of dichotomous choice and open-ended contingent values with auction values.Environ Resource Econ. 2001; 18: 275-292
- Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department.Acad Emerg Med. 2003; 10: 390-392
- Medical Treatment Utilization Schedule (MTUS) Chronic Pain Medical Treatment Guidelines, State of California, Sacramento, CA.California Department of Industrial Relations, Sacramento, CA2016
- Chiropractic clinical practice guideline: Evidence-based treatment of adult neck pain not due to whiplash.J Can Chiropract Assoc. 2005; 49: 158
- Responsiveness of the numeric pain rating scale in patients with low back pain.Spine. 2005; 30: 1331
- Nonpharmacologic therapies for low back pain: A systematic review for an American College of Physicians Clinical Practice Guideline.Ann Intern Med. 2017; 166: 493-505
- The willingness to pay for reducing pain and pain‐related disability.Value Health. 2009; 12: 498-506
- The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy.Spine. 2006; 31: 598-602
- Cervical spine injury medical treatment guidelines.Colorado Division of Workers' Compensation, Denver, CO2014: 96
- Low back pain medical treatment guidelines.Colorado Division of Workers' Compensation, Denver, CO2014: 112
- Chiropractic in the United States: Trends and issues.Milbank Q. 2003; 81: 107-138
- Researching the appropriateness of care in the complementary and integrative health (CIH) professions: Part 1.J Manipulative Physiol Ther. 2019; 41: 800-806
- The challenge of determining appropriate care in the era of patient-centered care and rising health care costs.J Health Serv Res Policy. 2019; 24 (doi:10.1177/1355819618815521): 201-206
- Chiropractic in North America: A descriptive analysis.J Manip Physiol Ther. 2005; 28: 83-89
- Willingness to pay for physician services: Comparing estimates from a discrete choice experiment and contingent valuation.Society and Economy. 2012; 34: 339-357
- A comparison of five low back disability questionnaires: Reliability and responsiveness.Phys Ther. 2002; 82: 8-24
- Studies with pain rating scales.Ann Rheum Dis. 1978; 37: 378-381
- Methods for the Economic Evaluation of Health Care Programmes.3rd ed. Oxford University Press, Oxford, UK2005
- The Oswestry low back pain disability questionnaire.Physiotherapy. 1980; 66: 271-273
- Management of chronic spine-related conditions: Consensus recommendations of a multidisciplinary panel.J Manipulative Physiol Ther. 2010; 33: 484-492
- Validation of the Oswestry low back pain disability questionnaire, its sensitivity as a measure of change following treatment and its relationship with other aspects of the chronic pain experience.Physiother Theory Pract. 1997; 13: 67-80
- Clinical practice guideline: Chiropractic care for low back pain.J Manipulative Physiol Ther. 2016; 39: 1-22
- Chiropractic management of low back disorders: Report from a consensus process.J Manipulative Physiol Ther. 2008; 31: 651-658
- Inter-correlation and test-retest reliability of the pain disability index (PDI) and the Oswestry disability questionnaire (ODQ) and their correlation with pain intensity in low back pain patients.Clin J Pain. 1993; 9: 189-195
- Characteristics of chiropractic patients being treated for chronic low back and chronic neck pain.J Manipulative Physiol Ther. 2018; 41: 445-455
- Coverage of nonpharmacologic treatments for low back pain among US public and private insurers.JAMA Network Open. 2018; 1 (-e183044)e183044
- Epidemiology: Spinal manipulation utilization.J Electromyography Kinesiol. 2012; 22: 648-654
- Measurement of pain.Lancet. 1974; 304: 1127-1131
- Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research.The National Academies Press, Washington, DC2011
- The prevalence of chronic pain in United States adults: Results of an Internet-based survey.J Pain. 2010; 11: 1230-1239
- Expenditures and health status among adults with back and neck problems.JAMA. 2008; 299: 656-664
- The association of complementary and alternative medicine use and health care expenditures for back and neck problems.Med Care. 2012; 50: 1029-1036
- The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire.Eur Spine J. 2007; 16: 2111-2117
- Theory versus practice: A review of 'willingness-to-pay' in health and health care.Health Econ. 2001; 10: 39-52
- Validity of a verbally administered numeric rating scale to measure cancer pain intensity.Cancer Nurs. 1997; 20: 88-93
- Neck Pain.Ann Intern Med. 2002; 136: 758-759
- Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017; 166: 514-530
- R: A language and environment for statistical computing.R Foundation for Statistical Computing, Vienna, Austria2018
- Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale.Eur J Pain. 2004; 8: 283-291
- The discrete-choice willingness-to-pay question format in health economics: Should we adopt environmental guidelines?.Med Decis Making. 2000; 20: 194-206
- Construction of the contingent valuation market in health care: A critical assessment.Health Econ. 2003; 12: 609-628
- Lost productive time and cost due to common pain conditions in the US Workforce.JAMA. 2003; 290: 2443-2454
- VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain, Version 2.0, The Office of Quality, Safety and Value, VA, & Office of Evidence Based Practice.U.S. Army Medical Command, Washington, DC2017
- Non-pharmacologic and non-opioid solutions for pain management.Quick Safety. 2018; (August:1-2)
- The Neck Disability Index: State-of-the-art, 1991-2008.J Manipulative Physiol Ther. 2008; 31: 491-502
- The Neck Disability Index: A study of reliability and validity.J Manipulative Physiol Ther. 1991; 14: 409
- Development of the Neck Pain and Disability Scale: Item analysis, face, and criterion-related validity.Spine. 1999; 24: 1290
This work was supported by the National Center for Complementary and Integrative Health of the National Institutes of Health [grant number 1U19AT007912-01]
The authors have no conflicts of interest to declare.