Abstract
Purpose: To evaluate whether the presence of leg pain influences healthcare use and work disability in patients with low back pain (LBP).
Methods: Prospective cohort study of primary care consulters with LBP in North Staffordshire and Cheshire. Patients completed questionnaires at baseline and 12 months, collecting data on back pain, work and healthcare utilisation. At baseline, patients were classified as reporting
-
LBP only,
-
LBP + leg pain above knee only or
-
LBP + leg pain extending below the knee.
Results: 456 patients had complete data and were included in this analysis. At baseline, 191 (42%) reported LBP only, 116 (25%) leg pain above the knee and 149 (33%) leg pain below the knee. In comparison to those with LBP only, patients reporting leg pain below knee were more likely to be referred to secondary care (46% vs 17%, p< 0.01), to re-consult their GP (68% vs 43%, p< 0.01) and to receive physiotherapy (40% vs 21%, p< 0.01) in the 12 months after baseline. At 12 months, those with leg pain below knee were less likely to be employed (67% vs 81%, p=0.01) than patients with LBP alone, more likely to have time off work (55% vs 31%, p< 0.01) or be on reduced work duties.
Conclusions: Self-reported leg pain is common. These patients access significantly more healthcare and are more likely to be off work over 12 months. This highlights the need for early identification of patients with concurrent leg pain and appropriate targeting of interventions to reduce work disability.
Conflicts of Interest: None
Funding source: Arthritis Research Campaign
Correspondence should be addressed to: SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
