Management of low back pain: Treatment provision within private practice in the UK in the context of clinical guidelines.

Abstract

OBJECTIVE\nTo summarise the combination of treatments private UK-based physiotherapists use with patients who have low back pain (LBP) and the extent to which the treatments used are consistent with clinical guideline recommendations.\n\n\nDESIGN\nCross-sectional observational survey.\n\n\nMETHODS\nData were collected from physiotherapists within private UK-based clinics using an online standardised data collection system to record the treatment they provided for patients who had LBP with/without leg pain. Treatment data were classified into those that are recommended , not recommended and had no recommendation .\n\n\nRESULTS/FINDINGS\nTreatment provided to 8003 patients were included in the analyses. Most patients (95.0%) were provided with a recommended treatment. Approximately half of the patients who received recommended treatment were also provided with other treatments that were either not recommended (16.7%), had no recommendation (16.6%) or a combination of both (13.0%). Few patients were provided with only treatments that were not recommended and/or treatment with no recommendation (4.6%).\n\n\nCONCLUSION\nThis study provides insight into the self-reported practice of participating physiotherapists and highlight how they generally adopted a multimodal treatment model for patients with LBP. Consistent with the National Institute for Health and Care Excellence guidelines, most patients received information and advice often in conjunction with exercise and manual therapy. Only a small proportion of patients were provided with treatments that are not recommended and/or treatment that had no recommendation . These findings are useful in documenting the implementation of clinical guidelines given the need for practitioners to balance the best available evidence with patient expectation and preference and to facilitate the therapeutic alliance.