Medical Physicians Ignore Low Back Pain Guidelines
A February 2010 study of 3,533 general practice low back pain patients found that many providers are not following their own evidence based guidelines.  Guidelines do provide the overall best evidence but are not meant to be a cookbook approach to care. There is also a need for flexibility so the physician can deviate from guidelines when the specific needs and desires of the patient dictate. In addition, the clinical judgment of the physician may override the guidelines when in a particular patient’s case they are inappropriate.
There is, however, reason for concern when risky and or expensive unneeded procedures are used. The medical guideline for acute low back pain call for advice and analgesics, but 80% of the 3,533 patients in this study were not given advise and 82% were not given analgesics. More harmful medications that are not recommended in the guidelines were prescribed, with 37% getting anti-inflammatory drugs and ~20% opiods.
Read the rest of this fascinating review at ChiroACCESS
You may also want to review contemporary research that documents the inadequacy medical training for musculoskeletal conditions.
1. Low back pain and best practice care: a survey of general practice physicians
Arch Intern Med. 2010 (Feb 8); 170 (3): 271-7