Abstract
Background: Patients assessed at the clinic are classified and managed according to the guidelines from The Royal College of General Practitioners. The purpose of this study was to evaluate the differences in initial assessment findings between patients with ‘simple’ LBP and those with probable ‘Nerve Root Pain’ (NRP).
Methods: All 1949 new patients attending over two years were assessed using a range of valid and reliable questionnaires to establish generic health status (Short-Form 36; SF36), self reported disability (Oswestry Disability Index; ODI) and psychological status (Hospital Anxiety and Depression Scale; HADS). The spinal examination was carried out by a Senior Physiotherapist and patients were triaged into the various categories of back pain. Differences between groups were assessed for the questionnaire scores and physical examination findings (SLR and lumbar flexion) using Chi-Square Analysis and unrelated T-Tests.
Results: 908 patients were classified as having ‘Simple’ LBP and 302 were classified as having probable ‘Nerve Root Pain’. A significant difference was detected between the two groups for the mean ODI scores (mean difference: −8.73; 95% CI –11.3 to –6.2; P< 0.001). (mean ODI of 36.73 % (SD 18.88%) for ‘Simple LBP’ and 45.46% (SD 22%) for NRP group. Significant differences were also detected for the SF36-Physical Component scores, lumbar flexion and SLR.
Conclusion: The ODI was found to be the strongest discriminator between the two groups. These findings support the inclusion of this condition specific outcome measure in the triage of back pain patients, as it appears to be sensitive to those patients with ‘NRP’.
Correspondence should be addressed to SBPR c/o Royal college of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
