Low back pain in Australian adults: Care seeking
Walker, B.F., Muller, R. and Grant, W. (2003) Low back pain in Australian adults: Care seeking. In: Annual Scientific Conference. Spine Society of Australia 2003, 25 - 27 April 2003, Canberra, A.C.T.
INTRODUCTION: There is no shortage of treatments for low back pain (LBP), including medication, injections, bed rest, physiotherapy, chiropractic, osteopathy, acupuncture, massage therapy, and surgery. In addition to this are a plethora of home and folk remedies. However, there is still doubt about the efficacy or effectiveness of even the most common forms of therapy1 • Also, little is known about the proportion of persons who seek care for LBP, why they sought care, the type of care sought and indeed what differentiates them from those who do not seek care at all. The objective of this study was to determine the characteristics of Australian adults who seek care for LBP, including the type of care they choose and any factors associated with making those choices.
METHODS: An age, gender and State stratified random sample of2768 Australian adults was selected from the Electoral Roll. This sample were mailed a fully structured questionnaire that included a series of questions relating to care-seeking for LBP, choice of provider and types of treatment received. In addition a series of questions were asked relating to demographic characteristics, socioeconomic variables, and severity of LBP. Also asked was cigarette smoking status, anthropometric variables, perceived cause oflow back pain, emotional distress, job satisfaction, physical fitness, past five year health status, and whether the subject feared LBP could impair their . work capacity or life in the future.
RESULTS: The survey response rate was 69.1 %. The sample proved to be similar to the Australian adult population. The majority of respondents with LBP in the past six months did not seek care for it (55.5%). Factors that increased care seeking were higher grades of pain and disability, fear of the impact of pain on future work and life and female sex. Factors decreasing the likelihood for seeking care were identified as the cause of pain being an accident at home and also never being married. General medical practitioners and chiropractors are the most popular providers of care.
DISCUSSION: High levels of pain and disability equating with higher levels of care-seeking would not surprise, however fear as a motivator for care-seeking has implications for clinical practice. Another important issue is the type of care selected for LBP. Using the best evidence available for the management ofLBP is now seen as a responsibility for all practitioners. It would be useful to compare care-seeking with the evidence of the efficacy and effectiveness of the various therapies utilised.
REFERENCES: 1. Cochrane Back Review Group. The Cochrane Library. Available at: http://www.cochrane.org/cochrane/revabstr/g05hindex.htm
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