Management of mechanical low back pain: A survey of beliefs and attitudes in GPs from Leicester and Nottingham

Abstract

Mechanical low back pain creates a significant economic burden in the industrial world. The costs of treating mechanical back pain in terms of sickness absenteeism and compensation claims are increasing rapidly.1-3 There is robust evidence that staying active and continuing or resuming ordinary activities is more effective than rest in the management of mechanical back pain.4 This evidence in the international literature has been incorporated in a set of Clinical Guidelines produced by the Royal College of General Practitioners (RCGP).5 These guidelines recommend that early investigation and referral to a specialist for simple mechanical back pain are unwarranted in most cases. Positive advice to stay active and continue ordinary activities is emphasised. The RCGP guidelines recommend the use of educational material for patients in the form of The Back Book, to reinforce positive messages.6 This book has been shown to be clinically effective in a randomised, controlled trial.7 A comparative study from Australia8 showed that a public education campaign based on The Back Book had a positive effect on GP management of mechanical back pain and related morbidity.