Care for low back pain: can health systems deliver?

One survey of 6588 con- to the recommended multidisciplinary health services and irrespective of the sultations for low back pain in Australia approach to pain management.17 A more number of chronic conditions a patient found that only around one fifth (21 of recent qualitative study of general prac- has. [...] For chronic low back pain, a pro- 100) of general practitioners performed titioners in the United Kingdom of Great gramme of primary care-based cogni- a complete history and physical exami- Britain and Norther Ireland concluded tive behavioural therapy can consist of nation.26 the same; one general practitioner seven sessions20 and a programme of Most of the recommended second- viewed recommendati [...] Recommended by 4 out of 6 guidelines.11–14 • First step care for low back pain, which will be sufficient for many patients, is to provide advice to remain active, education on the benign nature of low back pain and reassurance about the absence of serious pathology. [...] Recommended by 4 out of 6 guidelines.11–13,15 • Third step in chronic low back pain care is multidisciplinary pain management (targets physical, psychological and social aspects of low back pain and involves a team of clinicians). [...] I have gained such a lot from doing things for myself, and I like the idea of recommending and funding more help and support for other patients with back pain to learn how to do the same – and shifting from care being all about drugs and injections.” Example 2 A former nurse who has had back pain for many years: “I started with back pain when I was 30 [years old] and it became so bad when I was nu