Outcome of low back pain in general practice

BMJ 1998;317:1083 ( 17 October )

Letters

Outcome of low back pain in general practice

Evidence based practice can improve outcome

Study's methods may have altered patients' perceptions of their pain

Use of disease specific questionnaire may have influenced results

Authors' reply

Evidence based practice can improve outcome

The first 150 words of the full text of this article appear below.

EDITOR $---$ Croft et al describe 12 month outcome in low back pain.¹ Their paper documents the disease course, but it is surprisingthat they do not describe patient management. The Royal Collegeof General Practitioners has published evidence based guidelinesfor the management of acute back pain. ² ³ These guidelinesrecommend active management followed by manipulative treatmentat 4-6 weeks if active management fails. An evidence based bookfor patients with back pain (The Back Book) was launched withthe guidelines.⁴

We believe that evidence based management of acute back pain will improve outcome. While undertaking a prospective randomisedcontrolled trial of manipulative treatment that aimed to comparethe outcome of osteopathy and of physiotherapy we inadvertentlyshowed the effectiveness of the college's guidelines. Two generalpractices in Kingston-upon-Hull participated in this study, witha total practice population of 15 000. Both practices are in deprivedareas.

All patients presenting with . . . [Full text of this article]

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Outcome of low back pain in general practice: a prospective study: Peter R Croft, Gary J Macfarlane, Ann C Papageorgiou, Elaine Thomas, and Alan J Silman
BMJ 1998 316: 1356-1359. [Abstract] [Full Text] [PDF]

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