Back pain. Diagnosis and treatment according to evidence-based guidelines - options and limitations

Research areas: High tech medicine, Rehabilitation and occupational therapy

Project lead: Rosemarie Felder-Puig
Duration: June 2007 - Juli 2008

Background:
Nonspecific acute and chronic back pain, primarily in the lower back, are amongst the most frequent pain problems, although estimates of their prevalence and economic consequences vary greatly between studies. Since 2000 there has been increasing support in the literature for favouring proactive and educational therapies over passive and surgical procedures. Although a number of systematic reviews, HTAs and guidelines are available for diagnosis and treatment of back pain, it seems that the evidence often does not inform everyday clinical decisions of physicians and/or the acceptance and compliance of patients. Nevertheless, there is widespread agreement that adherence to evidence-based practice will help improve back pain patient outcomes and reduce costs.

Aims and research objectives:
The aim of this HTA is to provide a systematic review of current best evidence of effective prevention strategies and diagnostic and therapeutic modalities. We will address discrepancies in recommendations across guidelines, their methodological quality and the fact that most of them are monodisciplinary rather than multidisciplinary. Furthermore, we will broach the issue of scarce availability of high quality information for patients.

Method:
Evaluation of current German-language guidelines and comparison to results of recent meta-analyses, systematic reviews and HTAs; collection of Austrian epidemiological data; experts' opinions about practice and discrepancies.

Publication: HTA-Projektbericht 12

Contact: Rosemarie Felder-Puig