Low back pain in primary care: a description of 1250 patients with low back pain in danish general and chiropractic practice.

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

doi:10.1155/2014/106102

Lise Hestbaek, Alice Kongsted + Show 4 more

Open Access

https://doi.org/10.1155/2014/106102

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Abstract

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. 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.

Highlights

Low back pain (LBP) is the leading cause for years lived with disability worldwide [1] and the cost for society is huge
Four out of five patients had had previous episodes, one-fourth were on sick leave, and the low back pain (LBP) considerably limited daily activities
The 139 nonresponders tended to have a less severe profile, based on potential prognostic factors registered by the general practitioners, than responders: they were younger and more often males and had less leg pain, less sick leave, fewer previous episodes, and a shorter duration

Summary

Introduction

Low back pain (LBP) is the leading cause for years lived with disability worldwide [1] and the cost for society is huge. 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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