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Spine

EPIDEMIOLOGICAL PROFILE OF PATIENTS CONSULTING IN PRIMARY CARE WITH BACK AND LEG PAIN: CROSS-SECTIONAL FINDINGS FROM THE ATLAS STUDY

The Society for Back Pain Research (SBPR) Annual General Meeting 2014



Abstract

Background

60% of back pain patients report pain radiation in the leg(s), which is associated with worse symptoms and poorer recovery. The majority are treated in primary care, but detailed information about them is scarce. The objective of this study is to describe the characteristics of patients with back and leg pain-seeking treatment in primary care.

Methods

Adult patients consulting their GP with back and leg pain were invited to the study. Participants completed questionnaires including sociodemographic, physical and psychosocial measures. They also underwent standardised clinical assessments by physiotherapists, and received an MRI scan.

Results

609 patients participated with 67.5% reporting pain below the knee. 62.6% were female, sample mean (SD) age 50.2 (13.9). 367 (60.7%) were in paid employment with 39.7% reporting time off work. Mean disability (RMDQ) was 12.7 (5.7) and mean pain intensity was 5.6 (2.2) and 5.2 (2.4) for back and leg respectively. Mean sciatica bothersomeness index (SBI) score was 14.9 (5.1). 74.2% (452/609) were clinically diagnosed as having sciatica. Patients in the sciatica group reported significantly higher levels of leg pain and SBI scores, leg pain worse than back pain and pain below the knee. Neuropathic pain was more prevalent in patients with referred leg pain.

Conclusion

This primary care cohort reported high levels of disability and pain. Three quarters were diagnosed with sciatica. Follow-up of this cohort will investigate the prognostic value of their baseline characteristics.

This abstract summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0707-10131). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting

Conflicts of interest: No conflicts of interest

K. Konstantinou is supported by a HEFCE/NIHR Senior Clinical Lectureship. KM Dunn is supported by the Wellcome Trust (083572).