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Back Pain Assessment and Advice in Primary Care

Previous studies of low back pain indicate positive outcomes if the patient resumes their daily activities and routine. This study examined how primary care physicians evaluate the functional limitations of a low back pain patient, or what guidance they suggest about returning to normal activities.

The researchers found that providers failed to inquire about the back pain interference with the patient's job or activity. In 40% of the visit, functional impairments were not discussed. And 81% of the patients did not receive information on how to resume regular activities. Therefore, an assessment of functioning status, and advice to resume normal activities was not given consistently in primary care visits. The authors stress:

"Considerable research findings support the importance of psychosocial factors in back pain, disability, and health care use, and in predicting future back pain and disability...How the health care provider perceives the patient's back pain problem and communicates that perception to the patient may well influence the patient's attitudes and behavior relating to functional limitations and seeking health care."

From this study, it is clear that most doctors are not performing this function adequately.

Turner JA, LeResche L, Von Korff M, Ehrlich K. Back pain in primary care: patient characteristics, content of initial visit, and short-term outcomes. Spine 1998;23:463-469.