Doctors Offer a Mixed Bag of Recommendations to Patients with Low Back Pain
Opinions. Everyone's got one, including doctors who make recommendations to their back patients about activity and work levels. A recent mail survey indicates that these recommendations vary widely. The results also show that most doctors tend to restrict the activities of their patients with back pain.

The authors mailed survey packets to 142 doctors. The surveys included questions about their training and their expertise in treating back patients. To see what they would recommend for their back patients, each doctor was given information detailing the condition of three mock patients, each with a different back problem. The physicians were asked to give their impression about how bad each patient's problem was and to give recommendations about activity and work levels for each patient.

There was general agreement that patients with chronic back pain should limit their activities and work duties. Doctors also tended to restrict activity if the patient's symptoms were severe. And the responses showed that doctors based their recommendations on their own personal viewpoints and attitudes about pain. These factors had more to do with the doctors' decisions than current trends and recommendations for people with chronic low back pain. A newer approach shows improved results when patients with back pain swiftly return to normal activity.
James Rainville, MD, et al. Exploration of Physicians' Recommendations for Activities in Chronic Low Back Pain. In Spine. September 1, 2000. Vol. 25. No. 17. Pp. 2210-2220.