Management Of Mechanical Back Pain Research Articles

Awareness and knowledge of the common features of inflammatory back pain among primary care physicians in the western region of Saudi Arabia.

Often, there is a delay in the diagnosis of inflammatory back pain (IBP) in the primary care setting. This may be attributed to the inability of healthcare providers to distinguish between inflammatory and mechanical back pain. This study aimed to evaluate primary care physicians' current practices for assessing patients with IBP using clinical, radiographic, and laboratory tests. A questionnaire-based survey was emailed to all primary care physicians in the western region of Saudi Arabia by the Saudi Commission of Health Specialists from February to May 2021. The questionnaire included data about axial spondyloarthropathy based on the Calin, Berlin, and European Spondyloarthropathy Study Group criteria. A total of 103 primary care physicians responded who represented around 24% of primary care physicians at primary healthcare. The most often perceived IBP symptoms include a response to NSAIDs, morning stiffness lasting >30 minutes, age of onset <45 years old, duration of back pain >3 months, and improvement with exercise. The most frequently questioned patient or family history conditions were peripheral arthritis (92.2%), family history of spondyloarthritis (83.5%), and inflammatory bowel disease (97.6%). The most-reported investigations were CRP/ESR (86.4%) and spinal radiography (66%). For treatment of IBP, NSAIDs were most prescribed (48.6%), followed by physiotherapy (45.6%) and disease-modifying anti-rheumatic drugs (41.7%). Primary care physicians were more confident in management of mechanical back pain than IBP (P < .001). Primary care physicians have good knowledge of IBP symptoms but not of disease-specific features and modest confidence in evaluating patients with IBP, indicating the need for educational programs and a more effective, feasible referral strategy.

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

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.

Acute Low Back Pain: Diagnosis and Management of Mechanical Back Pain

Low back pain is the most common musculoskeletal complaint seen in an ambulatory care setting and affects 80 per cent of all persons at some time in their lives. It is the number one cause of activity restriction in people under 45. With the exception of progressive neuromotor compromise, the initial treatment of nearly all causes of LBP is conservative: the use of analgesics and/or anti-inflammatory agents, bed rest, and patient education.