Specified diagnosis in 532 cases of back pain

In the city of Malmö, Sweden, a project was started to improve the rehabilitation of patients with back pain. Among 532 patients with back pain who were on sick leave for an average of 98 days the year preceding the consultation, very few specific diagnoses were made in spite of a thorough clinical and radiological examination. Only five of the patients were cured by surgery. During the same period 103 patients were operated on for disc herniation or nerve root stenosis at the Orthopaedic Department at Malmö General Hospital. Thus the routines for somatic diagnosis of the medical service in Malmö are adequate and an improvement would have very little effect on the expenditures for sick leave and early retirement. As suggested in this paper social and psychological factors are of greater importance in the rehabilitation and we should focus less on the physical problems of the patient.