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The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons

Article Abstract:

Treatment outcomes appear to be similar but costs and levels of satisfaction vary widely for patients with low back pain who seek either medical or chiropractic treatment. Researchers compared treatment outcomes and satisfaction, number of office visits, and cost of treatment among 1,633 patients with low back pain. These patients had received care from either rural, urban, or managed care primary physicians, orthopedic surgeons, or rural or urban chiropractors. The average time that it took patients to return to a functioning level (16 days) was similar regardless of treatment type. Patients reported the greatest satisfaction with chiropractic treatment, followed by orthopedic and general medical treatments. However, chiropractic treatment required up to 15 office visits compared to 3 office visits with a primary care physician at a health maintenance organization (HMO), and cost substantially more.

Physicians (General practice), General practitioners, Chiropractors, Orthopedists

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The treatment of acute low back pain - bed rest, exercises, or ordinary activity?

Article Abstract:

The best and least costly treatment for backache may be to allow patients to continue their daily activities to the best of their ability. Researchers in Helsinki, Finland studied 186 city employees who visited the city's occupational health care centers with low back pain. Sixty-seven were told to take time off from work but to continue their regular activities (the control group), 67 were prescribed two days of bed rest and 52 were taught back exercises. All the patients returned to the clinic at three and 12 weeks. The patients in the control group went back to work sooner and had fewer days of pain. They also visited the clinic fewer times than the patients who exercised. Health care costs were similar in all three groups, but if the cost of lost work is factored in, the control group probably incurred the lowest cost.

Exercise therapy, Occupational therapy

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Lack of effectiveness of bed rest for sciatica

Article Abstract:

Bed rest does not appear to improve the symptoms of sciatica. Sciatica is pain caused by an inflammation of the sciatic nerve in the leg. Researchers randomly assigned 183 patients with sciatica to bed rest or no treatment. At two and 12 weeks, a similar percentage of both groups reported an improvement in their symptoms. Rates of work absenteeism and surgery were similar in both groups.

Sciatica

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