Primary care doctors' management of low back pain patients--ten years after

In 2001, we undertook a survey among general practitioners in Aust-Agder county to describe how patients with spinal problems were examined and treated by GPs. We have now conducted a new survey among the regular GPs in the same county.

All regular GPs in Aust-Agder county received an invitation to participate in the study. The doctors were asked to continuously register over two weeks all patients who visited the doctor and gave spinal problems as their main reason, and to describe all measures that were implemented after the consultation.

Of the 87 practising regular GPs, 53% responded. In total, the doctors had received 5,822 patients during the period of study, whereof 3% had reported spinal problems. The examination and treatment provided to these patients were on the whole unchanged since 2001. Only 41% of the doctors reported to cooperate regularly with a physiotherapist, and 11% with a chiropractor, a reduction from 73% and 35% respectively in 2001. The doctors reported co-morbidity in 37% of the patients. Patients were referred for diagnostic imaging with equal frequency as in 2001, although skeletal x-ray and CT had mainly been replaced by MRI.

The doctors in this sample treat patients with spinal problems in approximately the same way as the doctors in the 2001 survey, but cooperate less frequently with physiotherapists and chiropractors, and MRI has become the primary alternative when diagnostic imaging is requisitioned.