PCPs are front line defense in diagnosing serious illness in patients with acute lower...( A study by researchers at The George...),Health

A study by researchers at The George Institute for International Health in Australia found that it is rare for patients presenting to PCPs with acute lower back pain to have previously undiagnosed serious diseases. The most common serious disease cause documented was vertebral fracture, with half of the cases identified at the time of initial consultation. Full findings appear in the October issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

The World Health Organization (WHO) estimates that global prevalence of lower back pain could be as high as 42%. Pain occurring in the lower back interrupts daily routines such as work, school, or activities and is a chief cause of visits to primary care physicians (PCPs). According to The National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH), back pain is the second most common neurological ailment in the U.S. NINDS estimates Americans spend at least $50 billion each year due to low back pain, a leading contributor to missed work and job-related disability.

In this study a total of 170 general medical practitioners (Australian equivalent to PCP), physiotherapists, and chiropractors in the Sydney area were recruited. Between 2003 and 2005, the clinicians screened 3,184 patients with 1,172 presenting with acute low back pain. These patients were assessed for the presence of red flags for serious disease. The term "red flag" means danger and is used as a warning signal. In healthcare settings "red flag" clinical features, e.g. unexplained weight loss, are used by PCPs to screen for low back pain patients who are more likely to have a serious disease and so require more extensive diagnostic work-up.

Patients 14 years and older, presenting for the first consultation of the current episode of acute low back pain were included in this study. Researchers m
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