title: Clinical management of occupational low back pain in Australia: what is the real picture?
abstract: BACKGROUND
  The aim of this study was to compare the clinical management of patients with occupational low back pain (LBP) presenting to secondary care practitioners in Australia with national and international practice guidelines.
  
  
  METHODS
  A consecutive cohort of 401 patients with LBP following a work injury was assembled at the time of referral to secondary rehabilitation. A comprehensive assessment was performed to collect demographic, clinical and occupational data, which were analysed using descriptive statistics. Clinical and occupational management data were compared with evidence-based guidelines for the management of LBP.
  
  
  RESULTS
  This study revealed that in this cohort presenting to secondary care, referral for guideline-based active treatment was delayed until, on average, 10 months post-injury; radiographic investigations had been ordered for almost every patient, including those presenting in the first three months of their injury; the prevalence of co-morbidities was high and there were signs that psychological distress was under-diagnosed.
  
  
  CONCLUSIONS
  This study reveals a lack of compliance with clinical guidelines for occupational back pain management in Australia.
authors.affiliation: Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia. j.hush@usyd.edu.au
authors.forename: Julia M
authors.initials: JM
authors.lastname: Hush
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D005239:Fear / Q000523:psychology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009784:Occupational Diseases / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D017410:Practice Guidelines as Topic; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires; D055815:Young Adult
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