[Knowledge, practice and attitudes to back pain among doctors, physiotherapists and chiropractors]

In Norway, only doctors, physiotherapists and chiropractors are authorised to examine and treat patients suffering from low back pain. This study compares knowledge, attitudes and practice among these professional groups.

All 1105 doctors, physiotherapists and chiropractors in three Norwegian counties received a questionnaire with one section about knowledge, one about the action that respondents would recommend for various diagnoses, and one focused on attitudes towards back pain.

The chiropractors had the largest number of back pain patients in their practice and expressed the highest degree of professional interest in the field. We found no essential differences regarding knowledge between the groups. 77 % of the physiotherapists would refer acute sciatica to a doctor, while only 24 % of the chiropractors would do so. 65 % of the doctors and 10 % of the chiropractors would refer a chronic low back pain patient for physical therapy. Doctors and physiotherapists have a longstanding tradition of mutual cooperation, while chiropractors only seldom seem to refer to other care providers. One in five doctors and chiropractors, and 13 % of the physiotherapists, refer an acute unspecific low back pain to plain X-ray, which is not in accordance with the guidelines. Very few health care providers regarded low back pain as disabling. There are also few professionals who believe it possible to find an exact cause for the back pain in the individual patient.