Outcome of subacute low back pain: influence of patients' and rheumatologists' characteristics.
OBJECTIVE
To assess the outcome of subacute low back pain, to identify the characteristics of patients and physicians which were related to outcome and to evaluate the influence of rheumatologists' beliefs about back pain on their following the guidelines for physical and occupational activity.


METHODS



METHODS
a longitudinal descriptive survey.


METHODS
a secondary care practice in France.


METHODS
266 rheumatologists; 440 patients with subacute low back pain.


METHODS
the main outcome measure was persistence of back pain 3 months after baseline evaluation. A self-administered questionnaire for physicians assessed attitudes and beliefs about back pain [Fear-Avoidance Beliefs Questionnaire (FABQ)], and one for patients assessed pain, perceived handicap and disability (Quebec Scale), anxiety and depression (Hospital Anxiety Depression Questionnaire), and beliefs about back pain (FABQ).


RESULTS
Forty per cent of patients had persistent low back pain at 3 months; 5.5% of these had sciatica. A total of 10% of rheumatologists and 68% of patients at baseline had a high FABQ physical score (phys; >14). Determinants of outcomes were work-related back pain [odds ratio (OR) = 3.37; 95% confidence interval (CI) 1.08-5.17], anxiety (OR = 2.41; 95% CI 1.44-4.09), sex (female OR = 2.03; 95% CI 1.30-3.18) and patients' beliefs about back pain at work (OR = 1.02; 95% CI 1.00-1.05). Physicians with high FABQ physical scores were less likely to follow guidelines on prescribing rest and occupational activity for back pain.


CONCLUSIONS
Back pain commonly persists 3 months later in patients with subacute low back pain. Patients and rheumatologists still have negative beliefs about back pain. Rheumatologists' beliefs influence their following guidelines on physical and occupational activities. National education programmes about low back pain are needed in France.
Poiraudeau
S
S
Service de Médecine Physique et Réadaptation, Hôpital Cochin (AP-HP), Université Paris 5, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. serge.poiraudeau@cch.ap-hop-paris.fr
Rannou
F
F
Le Henanff
A
A
Coudeyre
E
E
Rozenberg
S
S
Huas
D
D
Martineau
C
C
Jolivet-Landreau
I
I
Revel
M
M
Ravaud
P
P
D000208:Acute Disease; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009784:Occupational Diseases / Q000523:psychology / Q000534:rehabilitation; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012737:Sex Factors