BACK PAIN IN PRIMARY-CARE - PATIENT CHARACTERISTICS, CONTENT OF INITIAL VISIT, AND SHORT-TERM OUTCOMES

Study Design. Prospective study of patients making primary care visits for back pain. Objective, To examine the content of primary care visi ts for back pain in patients with little interference of pain with act ivities al the visit and 1 month later; high interference of pain with activities at the visit but not 1 month later; and high interference of pain with activities, both at the visit and 1 month later. Summary of Background Data. Advice about resumption of activities may be thera peutic for patients with back pain, but little is known about the exte nt to which primary care providers assess and respond to limitation of activities in patients. Methods. Audiotapes of primary care visits fo r back pain were coded for content. Patients indicated their goals for the visit and completed measures of pain and the pain's interference with activities, just before the visit and 1 month later. Results. In most visits, providers did not assess functional limitations related t o pain and did not discuss how to resume normal activities, although t his was a highly rated goal for most patients. Providers did not : app ear to assess or respond to patients differently according to how much pain interfered with their activities. However, in patients with high interference of pain with activities, there was more discussion of li mitation of activities and how to return to usual activities among tho se who improved than there was among those who did not improve during the next month. Conclusions. Although back pain frequently is associat ed with limitation of activity, pain's interference with activities is assessed inconsistently in primary care visits.