Orthopaedists' and Family Practitioners' Knowledge of Simple Low Back Pain Management

Finestone A, MD, Raveh A, MD, Mirovsky Y, MD, et al. Spine 2009;34(15):1600-3.

Study to compare the knowledge of orthopedic surgeons & family physicians in managing simple LBP with reference to currently published evidence-based guidelines. Little is known about MDs' knowledge of the guidelines. 253 orthopedists & 140 family MDs at their annual professional meetings answered a questionnaire regarding management of simple LBP. Answers were scored based on the national guidelines for management of LBP. Results. The mean family practitioners' score (69.7) was significantly higher than the orthopaedists' score (44.3). Most orthopedists incorrectly responded that they would send their Pts for radiographs. They would also preferentially prescribe cyclo-oxygenase-2-specific NSAIDs, despite the guidelines recommendations to use paracetamol or nonspecific NSAIDs. Significantly less importance was attributed to patient encouragement & reassurance by orthopedists. Conclusion: Both orthopedists & family physicians' knowledge of treating LBP is deficient. Orthopedic surgeons are less aware of current treatment guidelines than family MDs. The importance of publishing & updating guidelines cannot be over stressed, however, disseminating the knowledge to clinicians is also very important to ensure good practice.