Back pain treatment: one size does not fit all

 More organised and targeted treatment of back pain by GPs led to a 50% reduction in work absence, in a study published in the Annals of Family Medicine. And it doesn’t increase healthcare costs.

A team from Keele University looked at data from 922 people with lower back pain from five GP surgeries in Cheshire. Participants were split into two groups; those receiving usual care were compared with others who had been screened into low, medium or high risk of persistent disability and then matched with appropriate treatment.

People in the low risk group were advised on how to manage their back pain, helped with pain relief and reassured about their good prognosis. Others in the medium and high risk groups received more intensive treatments led by physiotherapists.

Results showed that those in the organised care group experienced modest improvements in physical function, fear avoidance beliefs, satisfaction with care and time off work.

They were prescribed fewer non-steroidal anti-inflammatory drugs and reported greater satisfaction with the results of their care. Their care cost less than usual and made big savings due to fewer days off work. In fact, this group of people had 30% fewer sickness certificates than those receiving usual care.

“This exciting research shows that stratified or targeted approach to managing back pain in primary care is effective, and challenges the ‘one-size fits all’ strategy that is currently recommended by national guidelines in which everyone with nonspecific back is offered the same treatment, irrespective of their risk of persistent problems,” says Prof Alan Silman from Arthritis Research UK. “Back pain is one of the leading causes of work place absence, and to be able to reduce this burden on society by getting more people back to work, as well as giving benefit to individuals is a fantastic outcome.”

Click here to read the original research.