PHYSICIAN VIEWS ABOUT TREATING LOW-BACK-PAIN - THE RESULTS OF A NATIONAL SURVEY

Study Design. Physicians were surveyed regarding their beliefs about t reatment efficacy for patients with low back pain. Objective. To docum ent physician beliefs about the efficacy of specific-treatments and th e extent to which these beliefs correspond to current knowledge Summar y of Background Data. Little is known about physician beliefs regardin g the efficacy of specific back pain treatments. Methods. A national r andom sample of 2897: physicians were mailed questionnaires that asked about 1) the treatments they would order for hypothetical patients wi th low back pain and 2) the treatments they believed were effective fo r beck pain. Responses were compared with guidelines suggested by the Ouebec Task Force on Spinal Disorders. Results. Almost 1200 physicians responded. More than 80% of these physicians believed physical therap y is effective, but this consensus was lacking for other treatments. F ewer than half of the physicians believed that spinal manipulation is effective for acute or chronic back pain or that epidural steroid inje ctions, traction, and corsets are effective for acute back paint Bed r est and narcotic analgesics were recommended by substantial minorities of physicians for patients with chronic pain. The Ouebec Task Force f ound little scientific support for the effectiveness of most of the tr eatments found to be in common use. Conclusions. The lack of consensus among physicians. could be attributable to the absence of clear evide nce-based clinical guidelines, ignorance or rejection of existing scie ntific evidence, excessive commitment to a particular mode of therapy, or a tendency to discount the efficacy of competing treatments.