New Tool Helps Diagnose and Manage Low Back Pain

During National Pain Week 2012, NPS and The George Institute for Global Health have jointly launched a new decision support tool to assist primary care clinicians diagnose and manage low back pain in line with best practice guidelines.

Professor Chris Maher, Director of the Musculoskeletal Division at The George Institute for Global Health, said that the new back pain tool — Back Pain Choices — synthesises recommendations from evidence-based practice guidelines in Australia, the UK and USA into a unified set of recommendations. It also incorporates individual patient preferences for assessments and treatments so by the end of the consultation the patient has an individually tailored management plan and/or information sheet.

“This new tool is a good example of patient-centred primary healthcare and aligns with the government’s vision for primary health care reform, emphasising the importance of patient-centred care, health literacy and self management,” Professor Maher said.

Current practice often involves referring patients with non-specific low back pain for imaging; but imaging is only required if serious conditions such as cancer, infection, or inflammatory arthritis are strongly suspected. Routine imaging wastes money, exposes patients to unnecessary radiation and does not lead to better outcomes. Guidelines recommend starting with simple advice, reassurance and analgesia; in many cases that is all that is required.

“This is where the Back Pain Choices tool really helps. It provides a low cost way of bridging the gap between current management of non-specific low back pain in primary healthcare and guideline-recommended management,” Professor Maher said.

“More than half of all Australians have experienced low back pain — and the costs of related care are more than $1 billion per year. This tool will no doubt go some way to improving practice in this area and reducing the associated financial burden.”

Back Pain Choices steps health professionals through the process of examining, diagnosing and treating low back pain.

NPS CEO Dr Lynn Weekes said that the tool worked as a communication mechanism that could be used to engage patients in discussion of low back pain treatment options. By taking this approach, both GPs and patients are made aware of the treatment options available and together they can decide on the most suitable treatment option.

“Low back pain is not always managed well in primary care, so we hope that providing best-practice evidence via the Back Pain Choices tool will support better management of low back pain and reduce unnecessary testing that doesn’t support diagnosis,” Dr Weekes said.

“The tailored patient information sheet helps clinicians explain to patients the decision/diagnosis and why it was made, and provides patients with takeaway information that can be reviewed at a later date.”

The four components of the tool are:

  • Assessment for serious pathology
  • Clinical assessment
  • Treatment considerations, and
  • Building a tailored patient information sheet

The Back Pain Choices tool will be promoted via NPS low back pain educators to GPs and other health professionals, and is now available free on the NPS website.