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Special Interest in Back Pain May Cause Treatment to Suffer

Australian physicians with an interest in back pain not up to date on latest evidence-based treatment

FRIDAY, May 22 (HealthDay News) -- Australian physicians with an interest in low back pain (LBP) or related fields harbor beliefs that are at odds with current evidence-based practice, according to a study in the May 15 issue of Spine.

Rachelle Buchbinder, Ph.D., of Cabrini Hospital in Melbourne, Australia, and colleagues mailed questionnaires to three randomly selected samples of general practitioners in Australia in 1997, 2000, and 2004 to determine their beliefs about LBP and whether they had been influenced by continuing medical education (CME). The physician subsets studied included those with special interests in LBP, musculoskeletal medicine, or occupational therapy, versus those with no special interest, and those who completed CME versus those who did not.

A total of 3,831 general practitioners responded. The researchers found that physicians with a special interest in LBP were more likely to believe that bed rest and inactivity were appropriate in the treatment of low back pain, compared to those with no special interest (relative risks, 1.89 and 1.55, respectively), and that lumbar spine radiographs are useful (relative risk, 1.36). There were no significant differences in the beliefs between those with a special interest in musculoskeletal medicine and those without a special interest. Only physicians with a special interest in occupational medicine and those who had recently completed CME had beliefs in concert with current evidence-based practice.

"A special interest in back pain is associated with back pain management beliefs contrary to the best available evidence. This has serious implications for management of back pain in the community," the authors conclude.

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