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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 outcomes of 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 types.

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 surgeon.

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.

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