How To Prevent Back Pain-Related Disability and Work Absence
They say if you see six doctors for low back pain that you'll get six different opinions about what to do. That may be true because research hasn't been able to identify one best treatment plan for everyone.
One thing that may help us plan treatment for patients is to identify prognostic and predictive factors. Prognostic factors are those things, which if present, are linked with a good or bad outcome. Predictive factors can be used to tell which kind of treatment works best for the patient.
Researchers tried to rank factors most important in preventing disability from back pain. They got a group of people together to sort this all out. The group included researchers, doctors, therapists, and other interested parties.
Everyone was given a list of 35 possible factors to put in order of importance. When the top eight items were listed, each participant was asked to rank them according to which ones could be changed or modified.
The group had a wide range of opinions on these two lists of rankings. Only two factors had strong consensus (agreement). They were: 1) that care provider reassurance has a high impact on getting people back to work, and 2) that back supports have little influence on whether people get back to work.
The researchers concluded that getting everyone to agree may not be the goal. Agreement doesn't necessarily mean a program is successful. In fact, consensus may result in a middle-of-the road approach to prevention. This may not be in the best interest of individual patients.
Wide spread disagreement about back pain and what to do to treat it is a fact. More research is needed to show what works and what doesn't work. It may be that one program won't work for everyone. Predictive and prognostic factors may help direct each back pain sufferer to just the right program.
Is There Consensus on Preventing Disability and Work Absence? In The Back Letter. April 2007. Vol. 22. No. 4. Pp. 38.