Back Pain Survey

Cure-Back-Pain.Org proudly presents the official online version of the back pain survey distributed worldwide by Sensei Adam Rostocki. This survey has already been taken by over nine hundred and fifty thousand (950,000) patients who were kind enough to provide their personal experiences with back pain.

The results of this survey are an important part of the research which fuels this website. One moment of your time will help other patients to cure their own pain.

Do something good for fellow patients around the globe. Share your experiences and maybe help to change a life.

No personal information acquired as part of this survey will be shared with any other entity. You will not be placed on any mailing list from your participation in this survey. The only email you will receive is a confirmation of your participation.

Please be honest and accurate with your survey.

Your results are important. This is your chance to make a real difference in the way back pain is diagnosed and subsequently treated. Thank you for your time and contribution.


Please note that all fields followed by an asterisk must be filled in.

Once again, thank you for taking the back pain survey.

You might also be interested in sharing your back pain story with us.

Thank you also to the many volunteers who continue to distribute the paper version of this survey. Your diligent work is much appreciated.

Back Pain > Back Pain Survey

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