GPs now have a new tool that predicts whether acute low back pain will become chronic
GPs now have access to a new tool that predicts whether acute low back pain will become chronic, with the aim to reduce unnecessary interventions and anxiety in low-risk patients.
The five-item screening questionnaire was developed from a study of 1230 patients with acute back pain and tested on a separate group of 1530 patients in Sydney primary care practices.
Screening with this tool could reduce unnecessary interventions by 40% in primary care, compared with a treat-all approach, the researchers wrote.
“There’s such a large group of patients with acute low back pain, and most will recover with minimal intervention,” study author Adrian Traeger, physiotherapist and PhD candidate at NeuRA research institute, said.
“But in the first couple of sessions it’s hard to know who is going to improve and who is going to do badly,” he said. “This tool improves the clinical ability to predict problems long term, and offers an opportunity for GPs to provide information and discuss potential medication or physiotherapy benefits with their patients.”
The risk calculator is now online, and provides an immediate risk score.
Patients scoring 20% or lower could be confidently reassured that they had a very good prognosis, and those with a score above 20% could be considered for more intensive management, Mr Traeger said.
One of the challenges would be communicating the risk scores without frightening people who were already concerned about their back pain, Mr Traeger said.
Patients are asked about their leg pain, depression, pain intensity, disability compensation and whether they believe their pain may persist.
This is the first validated model designed to predict the onset of chronic low back pain in patients with a recent onset of pain, but more research is needed to determine the effectiveness of early intervention.
Find the calculator and information package at pickuptool.neura.edu.au.
PLOS Med 2016; online 17 May
