FRIDAY, July 10 (HealthDay News) -- Orthopedists, and to a lesser extent family practitioners, may have insufficient basic knowledge on the best management of simple low back pain, according to research published in the July 1 issue of Spine.
Aharon S. Finestone, M.D., of the Assaf HaRofeh Medical Center in Zeriffin, Israel, and colleagues analyzed data from a questionnaire on managing simple low back pain completed by 140 family practitioners and 253 orthopedists attending annual professional meetings.
The researchers found that 8 percent of family physicians and 53 percent of orthopedists incorrectly recommended the use of cyclooxygenase-2 selective nonsteroidal anti-inflammatory drugs as the preferred treatment, as opposed to paracetamol and nonselective nonsteroidal anti-inflammatory drugs. The same number of doctors failed to respond that imaging was not necessary. The authors further note that 46 percent of family physicians and 67 percent of orthopedists incorrectly supported some form of bed rest. Family practitioners' mean score (69.7) was significantly higher than orthopedists' mean score (44.3).
"In most medical systems orthopedists are not providers of treatment for simple low back pain. The orthopedists however, should know the guidelines of primary treatment. When a low back patient is not found to have surgical indications by an orthopedist, the use of treatment guidelines is important," Finestone and colleagues conclude. "Because of the differences between orthopedic surgeons and family practitioners, both in their training, clinical practice, and knowledge as shown in this study, different guidelines and knowledge enforcement programs may be necessary."
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