Low Back Pain: With Special Reference to Prevalence, Diagnosis, Treatment and Prognosis

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Bogefeldt, Johan,1969-Uppsala universitet,Institutionen för folkhälso- och vårdvetenskap,Allmänmedicin och klinisk epidemiologi (author)

Low Back Pain : With Special Reference to Prevalence, Diagnosis, Treatment and Prognosis

BookEnglish2009

Publisher, publication year, extent ...

Uppsala :Acta Universitatis Upsaliensis,2009
78 s.
electronicrdacarrier

Numbers

LIBRIS-ID:oai:DiVA.org:uu-108070
ISBN:9789155476014
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108070URI

Supplementary language notes

Language:English
Summary in:English

Part of subdatabase

SwePubSwePub

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Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine,1651-6206 ;481

Notes

Objectives. Ascertain if there has been a secular trend in 3-months prevalence of casually reported back pain. Evaluate if such back pain predicts concurrent health as well as future sick leave, disability pension, hospitalization and survival. Study differences in diagnostic assessment and labelling between physicians. Evaluate if a comprehensive manual therapy programme reduces sickness absence. Materials and methods. Combined population samples from 1973 to 2003 with a total of 12,891 observations with self-reported back pain and covariates. 7,074 of these individuals were followed for an average of 8.5 years and outcomes were self-reported health as well as official register data on sick leave, disability pension, hospitalisation and mortality. The Gotland Low Back Pain Study, a randomised controlled trial with participation of two general practitioners and two orthopaedic surgeons treating 160 patients with acute/subacute low back pain, with 10 weeks diagnostic evaluation and treatment and a two-year follow up. Results. Back pain prevalence increased 16% per ten years (OR 1.16, 95%CI 1.11-1.22). Back pain was negatively associated with self-rated health (p<0.0001), increased the risk of disability pension (p<0.002), and hospital admissions (p<0.0005), but not number of days in hospital, sick leave or mortality. General practitioners used terms from manual medicine and reported more pseudoradicular pain, while orthopaedic surgeons used non-specific pain labels, reported more true radicular pain and used more x-ray examinations. Among those on sick leave at baseline, manual therapy patients showed faster return to work (HR 1.62, 95%CI 1.006–2.60) and a lower point-prevalence of sick leave than reference patients at end of treatment period (ratio 0.35, 95% CI 0.13–0.97) but not after two years. Conclusions. There was a strong secular trend towards increase in self-reported back pain from 1973 to 2003. Such pain had a negative effect on some of the health outcomes and does not appear to be harmless. Physicians from different specialities labelled the condition differently. The manual therapy programme proved to be more effective than the established treatment regarding return to work.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
cohort study
time trends
sickness absence
randomised controlled trial
practice patterns
observer variation
Family medicine
Allmänmedicin
Allmänmedicin
Family Medicine

Added entries (persons, corporate bodies, meetings, titles ...)

Svärdsudd, Kurt,ProfessorUppsala universitet,Allmänmedicin och klinisk epidemiologi (thesis advisor)
Blomberg, Stefan,DrUppsala universitet,Allmänmedicin och klinisk epidemiologi (thesis advisor)
Eriksson, Margaretha,DrUppsala universitet,Allmänmedicin och klinisk epidemiologi (thesis advisor)
Nilsson, Gunnar,ProfessorKarolinska institutet (opponent)
Uppsala universitetInstitutionen för folkhälso- och vårdvetenskap (creator_code:org_t)

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