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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

      52,235 Monthly downloads/views I 2.832 Impact Factor I 4.5 CiteScore I 1.2 Source Normalized Impact per Paper (SNIP) I 0.655 Scimago Journal & Country Rank (SJR)

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      Patterns of health care utilization for low back pain.

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          Abstract

          The purpose of this study was to determine if primary care patients with low back pain (LBP) cluster into definable care utilization subgroups that can be explained by patient and provider characteristics.

          Most cited references27

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          Lost productive time and cost due to common pain conditions in the US workforce.

          Walter Stewart, Judith Ricci, Elsbeth Chee … (2003)
          Common pain conditions appear to have an adverse effect on work, but no comprehensive estimates exist on the amount of productive time lost in the US workforce due to pain. To measure lost productive time (absence and reduced performance due to common pain conditions) during a 2-week period. Cross-sectional study using survey data from the American Productivity Audit (a telephone survey that uses the Work and Health Interview) of working adults between August 1, 2001, and July 30, 2002. Random sample of 28 902 working adults in the United States. Lost productive time due to common pain conditions (arthritis, back, headache, and other musculoskeletal) expressed in hours per worker per week and calculated in US dollars. Thirteen percent of the total workforce experienced a loss in productive time during a 2-week period due to a common pain condition. Headache was the most common (5.4%) pain condition resulting in lost productive time. It was followed by back pain (3.2%), arthritis pain (2.0%), and other musculoskeletal pain (2.0%). Workers who experienced lost productive time from a pain condition lost a mean (SE) of 4.6 (0.09) h/wk. Workers who had a headache had a mean (SE) loss in productive time of 3.5 (0.1) h/wk. Workers who reported arthritis or back pain had mean (SE) lost productive times of 5.2 (0.25) h/wk. Other common pain conditions resulted in a mean (SE) loss in productive time of 5.5 (0.22) h/wk. Lost productive time from common pain conditions among active workers costs an estimated 61.2 billion dollars per year. The majority (76.6%) of the lost productive time was explained by reduced performance while at work and not work absence. Pain is an inordinately common and disabling condition in the US workforce. Most of the pain-related lost productive time occurs while employees are at work and is in the form of reduced performance.
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            Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey.

            D Cherkin, Marcia Hart, R Deyo (1995)
            This study is an analysis of national survey data from 5 sample years. The authors characterized the frequency of office visits for low back pain, the content of ambulatory care, and how these vary by physician specialty. Few recent data are available regarding ambulatory care for low back pain or how case mix and patient management vary by physician specialty. Data from the National Ambulatory Medical Care Survey were grouped into three time periods (1980-81, 1985, 1989-90). Frequency of visits for low back pain, referral status, tests, and treatments were tabulated by physician specialty. There were almost 15 million office visits for "mechanical" low back pain in 1990, ranking this problem fifth as a reason for all physician visits. Low back pain accounted for 2.8 percent of office visits in all three time periods. Nonspecific diagnostic labels were most common, and 56 percent of visits were to primary care physicians. Specialty variations were observed in caseload, diagnostic mix, and management. Back pain remains a major reason for all physician office visits. This study describes visit, referral, and management patterns among specialties providing the most care.
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              Low back pain: a twentieth century health care enigma.

              Paul Waddell (1996)
              Despite greater knowledge, expertise, and health care resources for spinal pathologies, chronic disability resulting from nonspecific low back pain is rising exponentially in western society. Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem. An historic review shows that there is no change in the pathology or prevalence of low back pain: What has changed in our understanding and management. There are striking differences in health care for low back pain in the United States and the United Kingdom, although neither delivers the kind of care recommended by recent evidence-based guidelines. Medical care for low back pain in the United States is specialist-oriented, of high technology, and of high cost, but 40% of American patients seek chiropractic care for low back pain instead. National Health Service care for low back pain in the United Kingdom is underfunded, too little and too late, and 55% of British patients pay for private therapy instead. Despite the different health care systems, treatment availability, and costs, there seems to be little difference in clinical outcomes or the social impact of low back pain in the two countries. There is growing dissatisfaction with health care for low back pain on both sides of the Atlantic. Future health care for patients with nonspecific low back pain should be designed to meet their specific needs.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): J Pain Res
                Title: Journal of pain research
                Publisher: Dove Medical Press Ltd.
                ISSN: 1178-7090
                ISSN (Print): 1178-7090
                Publication date (Electronic): 2015
                Volume: 8
                Affiliations
                [1 ] Geisinger Center for Health Research, Seattle, WA, USA.
                [2 ] Pfizer, Inc., Seattle, WA, USA.
                [3 ] Regeneron Pharmaceuticals, Inc., Seattle, WA, USA.
                [4 ] Group Health Research Institute, Seattle, WA, USA.
                Article
                Publisher Item ID: jpr-8-523
                DOI: 10.2147/JPR.S83599
                PMC ID: 4540213
                PubMed ID: 26316803
                SO-VID: c236ca55-72a0-4e3c-94d6-f8891029294e
                History

                Keywords: low back pain,back surgery,opioids,primary care,provider efficiency
                Data availability:
                Keywords: low back pain, back surgery, opioids, primary care, provider efficiency

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