Practice patterns when treating patients with low back pain

Low back pain (LBP), is a frequently reported musculoskeletal problem, affecting 75-85% of adults in their lifetime. Direct costs of LBP in the USA were estimated to be more than 85 billion dollars in 2005 resulting in a significant economic burden for the healthcare system. LBP classification systems and outcome measures are available to guide physical therapy assessments and intervention. Although, not much is known about which, if any, physical therapists use in clinical practice. The objective of this study was to identify the use of and barriers to LBP classification systems and outcome measures among physical therapists in one state. A mixed methods study using a cross-sectional cohort design with descriptive qualitative methods was performed. A survey collected both quantitative and qualitative data relevant to classification systems and outcome measures used by physical therapists working with patients with LBP. Physical therapists responded using classification systems designed to direct treatment predominantly. The McKenzie method was the most common approach to classify LBP. Barriers to use of classification systems and outcome measures were lack of knowledge, too limiting and time. Classification systems are being applied in decision-making in physical therapy practice for patients with LBP. Lack of knowledge and training seems to be the main hindrance to the use of classification systems in practice. The Oswestry Disability Index and Numerical Pain Scale were the most commonly used outcome measures. The main hurtle in their use was lack of time. Continuing education and reading the literature were identified as important tools to educate physical therapists in evidence-based practice