Costs and Utilities of Manual Therapy and Orthopedic Standard Care for Low Prioritized Orthopedic Outpatients of Working Age: A Cost Consequence Analysis.

Treatment for musculoskeletal disorders in primary care in Sweden is generally initiated with advice and medication. Second line therapy is physiotherapy and/or injection and radiography; third line therapy is referral to an orthopedist. Manual therapy is not routine. It is a challenge to identify patients who benefit from treatment by different specialists. The current referral strategy probably contributes to long waiting lists in orthopedic departments which is costly and implies prolonged suffering for the patients. The aim of this health economic evaluation is to compare costs and outcomes from naprapathic manual therapy (NMT) with orthopedic standard care for common, low prioritized, non surgical musculoskeletal disorders, after second line treatment.