Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey.
OBJECTIVE
Low back pain (LBP) is common, but sufferers pursue a range of management options and only some seek professional advice. This study examines how Australian consumers report that they manage LBP, with emphasis on the extent to which their practices match clinical recommendations and guidelines.


METHODS
A self-reported cross-sectional online survey comprising 29 questions in English (see Supplemental Digital Content 1, http://links.lww.com/CJP/A13) was conducted in February 2009. The internet-based survey sample was matched with national population proportions; 1220 respondents were screened and 1001 met the inclusion criteria (age >18 y and having suffered from back pain in the previous 6 mo).


RESULTS
A total of 570 (57%) participants had experienced LBP, of whom half (307; 54%) sought healthcare advice. Although 126 (41%) respondents reported receiving advice to exercise or stretch, only 107 (19%) reported that their initial response was to follow this advice. One-third maintained normal activity levels and 15% took bed rest, mostly for less than 1 day. A large proportion of respondents were overweight or obese (391, 68%); only 8% were active currently undertaking a weight loss regime. Taking analgesic medication was the most common initial action to LBP (449, 78% respondents); paracetamol was the predominant choice. Under-dosing was evident among users of over-the-counter analgesics.


CONCLUSIONS
The self-care choices that some people with LBP are making are not in line with the current evidence-based guidelines. This may lead to delayed recovery and the risk of medication-related problems. The provision of education about the nonpharmacologic management options for LBP, optimal information about appropriate medicines choices, and about medication contraindications is essential.
Wilk
Victor
V
Brighton Spinal Group, Brighton, VIC, Australia. vwilk@brightonspinal.com.au
Palmer
Hazel Denise
HD
Stosic
Rodney G
RG
McLachlan
Andrew J
AJ
D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D001315:Australia / Q000453:epidemiology; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D017116:Low Back Pain / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D012648:Self Care / Q000379:methods* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D015431:Weight Loss; D055815:Young Adult