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. 2010 Nov-Dec;15(6):392–400. doi: 10.1155/2010/252695

TABLE 5.

Results of studies assessing guideline compliance in low back pain (LBP) management – treatments*

Aspect of care Guideline concordant
Guideline discordant
Family physician Physiotherapist Chiropractor Family physician Physiotherapist
Acupuncture 21% (n=511) (29) 6% (n=159) (32) 45% (n=274) (36)
Bed rest 90% (n=193) (12), 66% (n=87) (31), 52% with sciatica (n=720) (28); mixed LBP: 74% (n=88) (34) (rest) 85% (n=255) (12); mixed LBP: 84% (n=66) (34) (rest) 100% (n=21) (12) 9% (n=87) (31), 19% (n=511) (29), 7% (n=845) (27), 59% without sciatica (n=720) (28); mixed LBP: 22% (n=88) (34) (rest) 0.1% (n=274) (36); mixed LBP: 14% (n=66) (34) (rest)
≥3 days 17% (n=139) (11), 7% without sciatica (n=720) (28), 25% with sciatica (n=720) (28)
Epidural steroid injection 1% without sciatica (n=720) (28), 11% with sciatica (n=720) (28)
Exercise 43% (n=139) (11), 65% (n=511) (29), 65% without sciatica (n=720) (28), 45% with sciatica (n=720) (28) Mixed LBP: 89% (n=25) (25)
Heat or ice 89% (n=87) (31) 66% heat, 82% ice (n=274) (36)
Injection therapy 52% (n=87) (31)
Massage therapy 66% (n=87) (31)
Medications 77% (n=139) (11)
  Acetaminophen 72% (n=87) (31), 49% without sciatica (n=720) (28), 46% with sciatica (n=720) (28)
  Antidepressants 23% (n=87) (31), 2% without sciatica (n=720) (28), 8% with sciatica (n=720) (28)
Muscle relaxants 83% without sciatica (n=720) (28), 67% with sciatica (n=720) (28) 91% (n=87) (31)
NSAIDs 98% (n=87) (31), 44% (n=511) (29), 93% without sciatica (n=720) (28), 87% with sciatica (n=720) (28)
Opioids 39% without sciatica (n=720) (28), 69% with sciatica (n=720) (28) 40% (n=139) (11), 62% (n=87) (31)
Opioids >2 weeks 1% without sciatica (n=720) (28), 5% with sciatica (n=720) (28)
Oral steroids 45% (n=87) (31), 4% without sciatica (n=720) (28), 24% with sciatica (n=720) (28)
Passive physiotherapy 66% (n=139) (11) (<4 weeks) 54% (n=139) (11) (>4 weeks)
Physiotherapy 57% (n=511) (29), 33% without sciatica (n=720) (28), 55% with sciatica (n=720) (28)
Spinal manipulation 6% (n=139) (11) (<4 weeks), 22% (n=87) (31), 20% (n=166) (32), 28% (n=511) (29), 6% without sciatica (n=720) (28) 30% (n=274) (36); mixed LBP: 3% (n=25) (25) 5% (n=139) (11) (>4 weeks), 3% with sciatica (n=720) (28)
Spinal mobilization 80% (n=274) (36)
Therapeutic ultrasound 55% (n=87) (31) 61% (n=274) (36); mixed LBP: 2% (n=25) (25)
Traction 55% (n=511) (29) Mixed LBP: 45% (n=1239) (35) 2% without sciatica (n=720) (28), 16% with sciatica (n=720) (28) 36% (n=274) (36); mixed LBP: 41% (n=1239) (35)
Transcutaneous electrical nerve stimulation 26% (n=511) (29) 4% without sciatica (n=720) (28), 12% with sciatica (n=720) (28) 53% (n=274) (36); mixed LBP: 4% (n=25) (25)
Trigger point injection 6% without sciatica (n=720) (28), 7% with sciatica (n=720) (28)
*

Unless stated otherwise, results are for acute/subacute LBP defined as less than 12 weeks’ duration. References for the condition descriptions used in the studies – acute/subacute LBP: 11,12,27–29,31–33,36; mixed LBP (acute or chronic LBP, or described as LBP): 25,26,30,34,35; and chronic LBP: 27,33. Countries: Australia (29); Canada (11,36); France (27); Italy (33); Northern Ireland (25); Norway (12); Sweden (30,34); United Kingdom (26,32,35) and the United States (28,31). NSAIDs Nonsteroidal anti-inflammatory drugs