Epidemiologie und Behandlung von Kreuzschmerzen in der Hausarztpraxis

Abstract

The clinical knowledge about incidence and course of low back pain in general practice is limited. To implement evidence based guidelines, it is indispensable to have full information on the health care situation. We performed a cross sectional study and a subsequent prospective cohort study on patients with low back pain (LBP) in general practice to learn more about the epidemiology, the history of pain, practioners care as well as patients perspective and expectations. Patients with LBP were asked to fill out questionnaires concerning pain characteristics and their expectations of health care. In telephone interviews (after 2 and 12 weeks) the history of pain and actual patterns of care were recorded. 35 general practioners (GPs) from South Oldenburg were invited, 17 (49%) participated. 127 patients filled in questionnaires, 49 patients took part in the interview after 2 weeks and 40 patients after 12 weeks. The mean prevalence of patients with LBP in general practice during one week was 7,9% (incidence 5,5%). 19% of all patients showed recurrent LBP. 55% of patients still suffered from daily or frequent pain after 12 weeks. More than half of the patients (54%) had already tried activity or pain killers to relieve their pain. They wanted their doctor to cure their pain (23% thought of injections to be the most useful therapy), not to initiate further diagnostic tests. GPs prescribed NSAIDs and used physical therapy and physiotherapy. 28,5% of the patients received an intramuscular injection therapy. Referrals were made to orthopaedic surgeons and neurologists, not to psychotherapists. GPs recommended activity for 62,5% of the patients, bed rest was not recommended at all. It seems that a large part of the patients and GPs are informed about the importance of an active treatment in LBP therapy. Still, there are GPs using not evidence based therapies or even obsolete ones. This might be reduced to patients expectations and requests.