title: Radiating low back pain in general practice: incidence, prevalence, diagnosis, and long-term clinical course of illness.
abstract: OBJECTIVE
  The aim of this study was to calculate the incidence and prevalence of radiating low back pain, to explore the long-term clinical course of radiating low back pain including the influence of radiculopathy (in a subsample of the study population) and non-radiating low back pain thereon, and to describe general practitioners' (GPs') treatment strategies for radiating low back pain.
  
  
  METHODS
  A historic prospective cohort study.
  
  
  METHODS
  Dutch general practice.
  
  
  METHODS
  Patients over 18 years of age with a first episode of radiating low back pain, registered by the ICPC code L86.
  
  
  METHODS
  Incidence and prevalence, clinical course of illness, initial diagnoses established by the GPs, and treatment strategies.
  
  
  RESULTS
  Mean incidence was 9.4 and mean prevalence was 17.2 per 1000 person years. In total, 390 patients had 1193 contacts with their GPs; 50% had only one contact with their GP. Consultation rates were higher in patients with a history of non-radiating low back pain and in patients with a diagnosis of radiculopathy in the first five years. In this study's subsample of 103 patients, L86 episodes represented radiculopathy in 50% of cases. Medication was prescribed to 64% of patients, mostly NSAIDs. Some 53% of patients were referred, mainly to physiotherapists and neurologists; 9% of patients underwent surgery.
  
  
  CONCLUSIONS
  Watchful waiting seems to be sufficient general practice care in most cases of radiating low back pain. Further research should be focused on clarifying the relationship between radicular radiating low back pain, non-radicular radiating low back pain, and non-radiating low back pain.
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen , the Netherlands.
authors.forename: Antje
authors.initials: A
authors.lastname: Spijker-Huiges
authors.forename: Feikje
authors.initials: F
authors.lastname: Groenhof
authors.forename: Jan C
authors.initials: JC
authors.lastname: Winters
authors.forename: Marten
authors.initials: M
authors.lastname: van Wijhe
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Meer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D058006:General Practice; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D011843:Radiculopathy / Q000150:complications* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D012017:Referral and Consultation; D055815:Young Adult
keywords: General practice; incidence; long-term care; lumbago; pain treatment; prevalence; sciatica; the Netherlands