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Giving patients their preferred back pain treatment raises its impact

By Mark Pownall

GPs who give patients with low back pain a treatment they prefer increase its effectiveness by about 50%, a new systematic review of back pain trials has found.

Professor David Torgerson, from the Trials Unit at the University of York told the European League against Rheumatism (EULAR) meeting in Copenhagen: ‘There is a 50% greater impact of whatever you do through giving people the treatment or other intervention they prefer.'

Guidelines from NICE published last month recommend that patients be offered a choice of treatment by GPs, if initial reassurance and advice was not effective, but did not identify the benefits on outcome of patient preference.

Professor Torgerson said those who showed a preference did better than those who were not bothered either way which management option they received.

The trials in the review tended to look at usual GP care, which tended to be a ‘watching and waiting' approach with a structured programme of exercise, manual therapy of some sort (physiotherapy, osteopathy or chiropractic) and acupuncture.

He said the review provided some reassurance that those who did not receive the treatment that they preferred did no worse than those who expressed no strong preference.

‘Preference can strongly affect the outcome in back pain patients, and a positive preference for one sort of therapy over another is especially associated with better outcome.'

Back pain: giving patients preferred treatment boosts results Back pain: giving patients preferred treatment boosts results

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