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New AHCPR-Supported Study on Low Back Pain
Reported in New England Journal of Medicine
Press Release Date: October 3, 1995
A study supported by the Agency for Health Care Policy and
Research (AHCPR), published in the October 5 issue of The New
England Journal of Medicine (NEJM), concludes that
patients with acute low back pain are similar regardless of the
type of practitioner initially seen.
The study, entitled "The Outcomes and Costs of Care for Acute
Low Back Pain Patients Seen by Primary Care Practitioners,
Chiropracters and Orthopedic Surgeons," was conducted by Timothy
S. Carey, MD, at the University of North Carolina at Chapel Hill.
The study enrolled, and followed for up to six months, a total of
1,633 patients from the practices of 208 North Carolina
practitioners. The participating practitioners were randomly
selected from six strata: urban and rural primary care medical
doctors, urban and rural chiropractors, orthopedic surgeons, and
practitioners in a group-model health maintenance organization.
Researchers found that patients' recovery time and the interval
in which they returned to work were similar for all practitioner
However, researchers found that patient satisfaction was greatest
among those initially seeing chiropractors, and that primary care
physicians provided care at the lowest cost. Both health care
utilization and estimated outpatient charges were highest when
the initial provider was a chiropractor or an orthopedic
The results of this study are consistent with the recommendations
contained in the AHCPR-supported clinical practice guideline on
acute low back pain. The guideline, released in November 1994,
advocates simple treatments such as nonprescription painkillers
and mild exercise followed by conditioning exercises beginning
two weeks after the pain first occurs for most cases of acute low
back problems. The guideline recommendations, which could save as
much as $5 billion annually if implemented, state that nine out
of 10 patients will recover on their own within a month.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.