Low back pain (LBP) is a common and costly condition.1, 2, 3 It is estimated that one in six Australians (approximately 3.7 million people, 13% of the population) experience LBP, and most (80% or 989, 483 people) report limitations in their daily activities.4 In Australia, the direct costs of LBP have been estimated at $4.8 billion.5 Several countries, such as the United Kingdom6 and USA,7 have produced clinical practice guidelines (CPGs) to help guide the management of LBP in primary care. Australian guidelines also exist although they are several years out of date.8, 9
Despite the availability of CPGs for the diagnosis and management of LBP, recent Australian surveys of people who self-manage their back pain10 and those managed by primary healthcare providers11 have revealed that care is often not evidence-based.1 In addition, our recent CareTrack Australia study demonstrated that, on average, people receive evidence-based care for LBP 72% of the time,12, 13 with particularly low compliance for documenting a thorough neurological examination, screening for serious diseases (such as infections), and inappropriate use of drugs (such as steroids) and treatments (such as traction).12 Therefore, the purpose of this wiki-based consultation process is to seek national agreement on what constitutes evidence-based and appropriate care for adults with LBP in Australia, and to organise this information within clinical indicators as a standard of care.
- Maher, C.G., Williams, C., Lin, C. and Latimer, J., 2011. Managing low back pain in primary care. Aust Prescr, 34(128), p.32.
- Walker B, Muller R, Grant W. Low back pain in Australian adults: the economic burden. Asia Pac J Public Health 2003;15:79-87.
- Walker B, Muller R, Grant W. Low back pain in Australian adults. Health provider utilization and care seeking. J Manipulative Physiol Ther 2004; 27:327-5.
- Australian Institute of Health and Welfare 2017. Back pain and problems. Available at: http://www.aihw.gov.au/back-problems/. Accessed: 8th March 2017.
- Arthritis and Osteoporosis Victoria & Deloitte Access Economics 2013, A problem worth solving: the rising cost of musculoskeletal conditions in Australia: a report, Elsternwick, [Victoria] Arthritis and Osteoporosis Victoria.
- National Institute for Health and Clinical Excellence. Early management of persistent non-specific low back pain. Quick reference guide. London: NICE; 2009.
- Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G. A., Shekelle, P., … Godges, J. J. (2012). Low Back Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. The Journal of Orthopaedic and Sports Physical Therapy, 42(4), A1–57. http://doi.org/10.2519/jospt.2012.42.4.A1
- Acute low back pain. In: Australian Acute Musculoskeletal Pain Guidelines Group. Evidence-based management of acute musculoskeletal pain. Brisbane: Australian Academic Press; 2003. p. 25-61.
- Rheumatology Expert Group. Therapeutic guidelines: rheumatology. Version 3. Melbourne: Therapeutic Guidelines Limited; 2017.
- Wilk V, Palmer HD, Stosic RG, McLachlan AJ. Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. Clin J Pain 2010;26:533-40.
- Williams CM, Maher CG, Hancock MJ, McAuley JH, McLachlan AJ, Britt H, et al. Low back pain and best practice care: a survey of general practice physicians. Arch Intern Med 2010;170:271-7.
- Ramanathan, S.A., Hibbert, P.D., Maher, C.G., Day, R.O., Hindmarsh, D.M., Hooper, T.D., Hannaford, N.A. and Runciman, W.B., 2016. Care Track: Towards Appropriate Care for Low Back Pain. Spine.
- Runciman, W.B., Hunt, T.D., Hannaford, N.A., Hibbert, P.D., Westbrook, J.I., Coiera, E.W., Day, R.O., Hindmarsh, D.M., McGlynn, E.A. and Braithwaite, J., 2012. CareTrack: assessing the appropriateness of health care delivery in Australia. Medical Journal of Australia, 197(10), p.549.