Abstract
Study DesignCross sectional data from the Yamaguchi low back pain study conducted in Yamaguchi prefecture, Japan, was used for this analysis.MethodsA total of 320 patients were recruited from walk-in orthopedic clinics in Yamaguchi Prefecture, Japan. Patients visited the clinics primarily for low back pain (LBP) and sought treatment between April and May 2015. A self-questionnaire was completed by patients, while radiographic testing and neurological and physical examination was performed by the orthopedist in each hospital. The cause and characters of LBP was determined following examination of the data, regional anesthesia and block injection.Results‘Specific LBP’ was diagnosed in 250 (78%) patients and non-diagnosable, ‘non-specific LBP’ in 70 (22%) patients. The VAS scores of patients were: LBP, 5.8±0.18; leg pain, 2.9±0.18 and the intensity of leg numbness was 1.9±0.16. Item scores for SF-8 were: general health, 46.6±0.40; physical function, 43.5±0.51; physical limitations, 42.8±0.53; body pain, 42.1±0.52; vitality, 48.4±0.37; social function, 46.9±0.53; emotional problems, 48.9±0.43; mental health, 46.9±0.43.ConclusionsThe incidence of non-specific LBP in Japan was lower than previous reports from western countries, presumably because of variation in the diagnosis of LBP between different health care systems. In Japan, 78% of cases were classified as ‘specific LBP’ by orthopedists. Identification of the definitive cause of LBP should help to improve the quality of LBP treatment.
Highlights
About one quarter of adults in Japan suffer from low back pain (LBP) [1]
The incidence of non-specific LBP in Japan was lower than previous reports from western countries, presumably because of variation in the diagnosis of LBP between different health care systems
Identification of the definitive cause of LBP should help to improve the quality of LBP treatment
Summary
About one quarter of adults in Japan suffer from low back pain (LBP) [1]. Worldwide, the cause of LBP is unclear in about 85% of patients and such cases are referred to as ‘non-specific LBP’ [2,3]. Careful examination by specialists can lead to more patients being diagnosed with a clear and treatable cause of LBP. Increasing the proportion of LBP cases with a clear diagnosis is important clinically because it allows proper treatment to begin early and this is the key factor for achieving improved outcome [4,5,6,7]. Earlier papers from North America reported on LBP diagnosis by primary care doctors at walk-in clinics and emergency hospitals [2,3]. These papers reported the proportion of diagnosable LBP with a clear cause was only 15–20% of patients with LBP. Japanese patients with LBP visit orthopedic clinics and are seen by specialist doctors
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