Which factors may affect the choice of treatment for mechanical low back pain?

Updated: Mar 06, 2018
  • Author: Everett C Hills, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Mechanical low back pain (LBP) is not a life-threatening illness. Unfortunately, it does have a far-reaching impact on medical care expenditures for injured workers. An in-depth examination of the impact of mechanical LBP on the US workers' compensation system, which varies from state to state, is beyond the subject of this article. Many interesting perceptions about mechanical LBP have been noted.

  • In studies in which subjects had to answer self-assessment instruments, patients with insurance referrals had poorer self-assessment scores regardless of functional status.

  • Among different health care providers, patients rated care and communication, followed by competence, over efficacy of treatment.

  • Chiropractors often have been favored over internists and orthopedic surgeons on the basis of their "high touch" approach to treatment.

  • Orthopedic surgeons were found to be less restrictive with activities compared with family practitioners.

  • In a Dutch study, factors such as better health, better job satisfaction, status as breadwinner, lower age, and reporting of less pain were favorable prognosticators of return to work in individuals who had not been working for more than 3 months. The authors of the study believed that more focus was necessary on the psychosocial aspects of health behavior and job satisfaction.

  • Exercise was found to be more effective than usual primary care management.


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