Oral Presentation Sydney Spinal Symposium 2018

Patients’ perspectives of primary care treatment for low back pain (#3)

Malene Ahern 1 , Catherine M Dean 1 , Blake F Dear 1 , Simon M Willcock 1 , Julia M Hush 1
  1. Macquarie University, NSW, Australia

The Global Burden of Disease study reports that low back pain (LBP) is the highest cause of disability in Australasia and globally.1 Evidence from clinical trials of treatments for patients with non-specific LBP show that outcomes are generally too small to be clinically worthwhile.2 A better understanding of patients’ experiences of treatment in primary care could help in designing more person-centered and effective interventions. The aim of this study was to investigate the experiences of people who have received treatment for LBP with a primary health care provider. Australian adults (N=426) who had experienced at least one episode of LBP in the past year and sought primary care treatment completed a cross sectional online survey. The majority (71%) reported their last episode of LBP was < 12 weeks duration, with 67% experiencing recurrent episodes. Moderate to high interference of pain was reported for work (70% of participants), activity (69%), enjoyment of life (67%), mood (65%) and sleep (60%). The majority (79%) of participants consulted multiple health care providers. Only 54% of participants reported they received education and very low proportions received guideline-based advice about avoiding prolonged bed rest (12%); resuming normal activity (35%); and that imaging is unlikely to be helpful (15%). The level of satisfaction with primary care treatment for LBP was below moderate for 42% of respondents. This study reveals that there are sustained gaps in primary care treatment for LBP and that there is a need for the management of LBP to better meet patients’ expectations and needs and align with clinical guidelines.

  1. Walker B, Muller R, Grant W. Low back pain in Australian adults. Health provider utilization and care seeking. Journal of Manipulative & Physiological Therapeutics 2004;27(5):327-335.
  2. Machado LAC, Kamper SJ, Herbert RD, Maher CG, McAuley JH. Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials. Rheumatology 2009;48(5):520-527.