Back treatment delayed due to work fears
A majority of physicians (87%) reported that patients with acute lower back pain waited three or more days before seeking medical help, according to a recent Internet survey of 378 primary care physicians. Furthermore, physicians indicated that the primary reasons for patients seeking help were that the condition interfered with their ability to work, to conduct daily activities, and because over-the-counter treatments (OTC) were ineffective.
The survey was sponsored by Pain.com, a Web site devoted to pain and its management for pain professionals and sufferers. Larry Vervack, exe-cutive director of the Dannemiller Memorial Educational Foundation in San Antonio, which sponsors the site, says the results were surprising.
"Acute lower back pain might be more of a national problem than we originally thought," he says. "It was especially surprising to learn that so many people waited for days before getting the help that they needed. People need to know that they don’t have to delay seeking help for their pain."
The survey was conducted via the Internet among 378 office-based primary care physicians by Market Measures Interactive. The survey was designed to determine how primary care physicians treat acute lower back pain. John Dombrowski, MD, director of the Center for Pain Medicine at Sibley Memorial Hospital in Washington, DC, says the survey results show that physicians should encourage patients to seek prompt treatment of back injuries.
"Most lower back pain sufferers will first try [OTC] analgesic drugs and bed rest. But for the majority, these self remedies will not provide the relief that they need," he says. "Lower back pain sufferers should see their physicians within the first 24 to 48 hours for proper diagnosis and treatment. The sooner they get help, the faster they will get relief. This translates into fewer missed worked days and needless spending on OTC drugs."
Patients unable to work
Additional survey results showed that more than half (54%) of all first-time visits to a primary care physician for acute lower back pain were because the patient was unable to work (29%) or conduct daily activities (24%). Twenty-five percent of patients visited a primary care physician because OTC treatments were ineffective.
The survey also found a strong connection between diet, exercise, and lower back health. Physicians reported that for nearly half (45%) of their patients with acute lower back pain, the pain was either caused by or aggravated by excessive weight. Prescription non-narcotic analgesics (70%) and muscle relaxants (66%) were the top treatment choices of physicians. Other recommended therapies included exercise (62%), heat therapy (59%), and/or rest (50%).
Virtually all physicians (98%) considered pain reduction one of their first three treatment goals, followed by reduced inflammation (59%), and relief of stress and/or muscle relaxation (40%). The survey was funded by an unrestricted grant from Elan Pharmaceuticals, a division of Elan Corporation, PLC.
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