Background: patient views and documented clinical results given by physicians prior to and after an intensive instructional course of basic back care and minimal manual therapy techniques were studied. A core group of caregivers completed a comprehensive pre-treatment assessment, consisting of detailed questions about the patient’s demographics, functioning, and back problems. Back pain was the most common non-symptomatic problem observed in the pre-treatment questionnaire and was rated in terms of severity, priority, incidence, management, and frequency. Post-treatment questionnaires focused on the use of prescription back support devices, modified activity plan, and exercise regimen. Of the 8 patients who completed the post-treatment questionnaire, all reported their satisfaction with their back care, with one exception; the patient with spinal stenosis was not happy with his or her treatment because his movements were painful and worsened as he became older. No significant differences in treatment between the stenosis patient and the other patients were noted.
Discussion: Based on the pre-treatment survey and a literature review, only three of the 14 physicians surveyed had enhanced back care protocols. These physicians had the greatest level of difficulty describing their standard back care protocol (e.g., which equipment is used, which patients are seen frequently, etc. ). Only three of the 13 physicians met the physicians’ criteria for a high level of practice, thereby implying that even more physicians would have difficulty describing their standard practice.
Outcome: The majority of physicians were able to improve their level of back care treatment and found their standard of care did not negatively impact their patients’ back pain. Furthermore, many physicians expressed they would continue to use traditional back care procedures if they were comfortable with the safety and benefits offered by their current method. This outcome implies that a high percentage of healthcare providers have little knowledge regarding the beneficial methods of relieving back pain. Achieving improved back care requires training, both prior to service and subsequent to service, from a healthcare provider’s perspective.