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Low Back Pain in Primary Care

Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

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SOURCE:   Int J Family Med. 2014 (Nov 4);   2014:   106102 ~ FULL TEXT

Lise Hestbaek, Anders Munck, Lisbeth Hartvigsen,
Dorte Ejg Jarbøl, Jens Søndergaard, and Alice Kongsted

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
5230 Odense, Denmark
l.hestbaek@nikkb.dk


Study Design.   Baseline description of a multicenter cohort study.

Objective.   To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark.

Background.   To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice.

Methods.   Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson’s chi-square test, were used to test for differences between the two populations.

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Results.   Questionnaires were returned from 934 patients in chiropractic practice and 319 patients from general practice. Four out of five patients had had previous episodes, one-fourth were on sick leave, and the LBP considerably limited daily activities. The general practice patients were slightly older and less educated, more often females, and generally worse on all disease-related parameters than chiropractic patients. All differences were statistically significant.

Conclusions.   LBP in primary care was recurrent, causing sick leave and activity limitations. There were clear differences between the chiropractic and general practice populations in this study.


From the FULL TEXT Article:

1. Introduction

Low back pain (LBP) is the leading cause for years lived with disability worldwide [1] and the cost for society is huge. In Denmark, the accumulated societal costs related to back pain were estimated at 2.8 billion US dollar in 2005, almost equivalent to one percent of the NGP [2], with the vast majority of the costs being spent on the minority of the cases that become chronic. Therefore, focus has centered on chronic patients in secondary and tertiary care settings whereas patients in primary healthcare have received less attention. This is in spite of almost all initial consultations occurring in primary care and musculoskeletal problems being one of the most common reasons for consultation. [3] Among politicians and health care planners, there is a growing awareness of the important role of primary care as the “first line of defense” in reducing chronicity and long-term disability. This has led to increased demands for implementation of clinical guidelines, quality assessment and assurance, consensus about “best treatment,” and so forth.


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