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Management of chronic nonspecific low back pain in primary care: a descriptive study
M W van Tulder1, B W Koes, L M Bouter
1Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Study Design:
A retrospective, descriptive study.
Objectives:
To describe the diagnostic and therapeutic procedures for patients with chronic low back pain in primary care.
Summary Of Background Data:
Most previous studies have described the management of acute low back pain, but little is known about the management of chronic low back pain in primary care.
Methods:
Twenty-six general practitioners involved in the Registration Network of Family Practices of the University of Limburg in The Netherlands participated in this study. All patients and general practitioners were asked to complete a retrospective questionnaire, and there was a 12-month follow-up.
Results:
The total study population consisted of 524 patients with chronic low back pain. Twenty-three percent of the patients had had radiographs taken during the previous 12 months, and 5% had been examined by other imaging techniques. Twenty-nine percent of the study population had not received and therapy at all, 46% had received medication, mostly (36%) nonsteroidal anti-inflammatory drugs (NSAIDs), and for 18% (bed)-rest had been advised. Thirty-six percent of the study population had been referred to a physiotherapist.
Conclusions:
The therapeutic management of chronic low back pain seems to lack consistency. Clinical guidelines are needed to improve the management of chronic low back pain in primary care.