Characteristics of patients with acute low back pain presenting to primary care in Australia

Abstract

Objectives: This study aimed to provide a comprehensive profile of a representative sample of patients with acute low back pain drawn from the primary care setting. A secondary aim was to determine whether patient characteristics are associated with pain intensity or disability at the initial consultation.

Methods: A total of 1172 consecutive patients with acute low back pain presenting to clinics of primary care practitioners (general practitioners, physiotherapists, and chiropractors) in Australia were recruited. Pain intensity and level of disability were measured at the first consultation, and a range of other variables were measured to describe the patient's characteristics. The characteristics were then grouped into 7 distinct factors: demographic, social, cultural, general health, psychologic, past low back pain history, and current low back pain history. Hierarchical linear regression models were used to determine each factor's independent relationship with pain intensity and disability.

Results: The majority of patients reported having had a previous episode of low back pain (75.7%), and that the current episode was of sudden onset (76.7%). Only a small proportion (14.3%) had compensable back pain. Pain intensity and disability were associated with each other (P<0.01), current low back pain history (P<0.01), and psychologic (P<0.01) characteristics.

Discussion: In a representative sample of acute low back pain patients in primary care, we found that the profile included only a small proportion of patients with compensable low back pain. Those without compensation were more likely to remain at work despite low back pain. Psychologic and other patient characteristics were associated with pain intensity and level of disability at the initial consultation.