CHRONIC LOW-BACK-PAIN IN PRIMARY-CARE - A PROSPECTIVE-STUDY ON THE MANAGEMENT AND COURSE

Background. There is little evidence about the management and course o f chronic low back pain in primary care. Objectives. Our aim was to de scribe the course of chronic low back pain and the performed diagnosti c and therapeutic procedures for patients with chronic low back pain i n general practice. Methods. Twenty-six GPs involved in the Registrati on Network Family Practices participated in this prospective follow-up study. All patients and GPs were asked to complete questionnaires at baseline and at 4, 8 and 12 months follow-up. Results. The GPs provide d information about diagnostic and therapeutic procedures concerning 5 24 patients with chronic low back pain. Diagnostic tests other than hi story-taking and physical examination were not frequently used. Medica tion, mostly NSAIDs, was the most frequently used type of treatment (2 1.6%). The most frequent referrals concerned physiotherapy (16.3%) and neurology or neurologic surgery (6.3%). Information about the course of their chronic low back pain was provided by 368 patients participat ing in our study. The course of chronic low back pain appeared to be q uite stable, as there was only a slight improvement in pain intensity and physical functioning over the 12 months of follow-up. Conclusions. A variety of options for the treatment and referral of chronic low ba ck pain patients is available for and used by GPs. Efforts should be m ade to establish which diagnostic and therapeutic procedures are the m ost effective for chronic low back pain.