Back Pain: Eriksen HR

Burton AK, Balagué F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Müller G, van der Beek AJ, Anonymous00001. · No affiliation provided · Eur Spine J. · Pubmed #16550446 No free full text.

This publication has no abstract.

Brox JI, Storheim K, Grotle M, Tveito TH, Indahl A, Eriksen HR. · Orthopedic Department, Rikshospitalet University, 0027 Oslo, Norway. · Spine J. · Pubmed #18164451 No free full text.

Abstract: The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. To help understand and evaluate the various commonly used nonsurgical approaches to CLBP, the North American Spine Society has sponsored this special focus issue of The Spine Journal, titled Evidence-Informed Management of Chronic Low Back Pain Without Surgery. Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts. Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.

Brox JI, Storheim K, Grotle M, Tveito TH, Indahl A, Eriksen HR. · Orthopedic Department, Rikshospitalet-Radiumhospitalet Medical University Center, 0027 Oslo, Norway. · Spine J. · Pubmed #18024224 No free full text.

Abstract: BACKGROUND: Seven previous systematic reviews (SRs) have evaluated back schools, and one has evaluated brief education, with the latest SR including studies until November 2004. The effectiveness of fear-avoidance training has not been assessed. PURPOSE: To assess the effectiveness of back schools, brief education, and fear-avoidance training for chronic low back pain (CLBP). STUDY DESIGN: A SR. METHODS: We searched the MEDLINE database of randomized controlled trials (RCT) until August 2006 for relevant trials reported in English. Assessment of effectiveness was based on pain, disability, and sick leave. RCTs that reported back schools, or brief education as the main intervention, were included. For fear-avoidance training, evaluation of domain-specific outcome was required. Two reviewers independently reviewed the studies. RESULTS: Eight RCTs including 1,002 patients evaluated back schools, three studies were of high quality. We found conflicting evidence for back schools compared with waiting list, placebo, usual care, and exercises, and a cognitive behavioral back school. Twelve trials including 3,583 patients evaluated brief education. Seven trials, six of high quality, evaluated brief education in the clinical setting. We found strong evidence of effectiveness on sick leave and short-term disability compared with usual care. We found conflicting or limited evidence for back book or Internet discussion (five trials, two of high quality) compared with waiting list, no intervention, massage, yoga, or exercises. Three RCTs of high quality, including 364 patients, evaluated fear-avoidance training. We found moderate evidence that there is no difference between rehabilitation including fear-avoidance training and spinal fusion. CONCLUSIONS: Consistent recommendations are given for brief education in the clinical setting, and fear-avoidance training should be considered as an alternative to spinal fusion, and back schools may be considered in the occupational setting. The discordance between reviews can be attributed differences in inclusion criteria and application of evidence rules.

Burton AK, Balagué F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Müller G, van der Beek AJ, Anonymous00032. · Centre for Health and Social Care Research, University of Huddersfield, 30 Queen Street, Huddersfield HD1 2SP, UK. · Best Pract Res Clin Rheumatol. · Pubmed #15949775 No free full text.

Abstract: This chapter summarizes the European Guidelines for Prevention in Low Back Pain, which consider the evidence in respect of the general population, workers and children. There is limited scope for preventing the incidence (first-time onset) of back pain and, overall, there is limited robust evidence for numerous aspects of prevention in back pain. Nevertheless, there is evidence suggesting that prevention of various consequences of back pain is feasible. However, for those interventions where there is acceptable evidence, the effect sizes are rather modest. The most promising approaches seem to involve physical activity/exercise and appropriate (biopsychosocial) education, at least for adults. Owing to its multidimensional nature, no single intervention is likely to be effective at preventing the overall problem of back pain, although there is likely to be benefit from getting all the players onside. However, innovative studies are required to better understand the mechanisms and delivery of prevention in low back pain.

Eriksen HR, Ursin H. · Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, N-5009 Bergen, Norway. · J Psychosom Res. · Pubmed #15094030 No free full text.

Abstract: INTRODUCTION: This review argues that "subjective health complaints" is a better and neutral term for "unexplained medical symptoms." The most common complaints are musculoskeletal pain, gastrointestinal complaints and "pseudoneurology" (tiredness, sleep problems, fatigue, and mood changes). These complaints are common in the general population, but for some these complaints reach a level that requires care and assistance. THEORETICAL ASSUMPTIONS: We suggest that these complaints are based on sensations from what in most people are normal physiological processes. In some individuals these sensations become intolerable. In some cases it may signal somatic disease, in most cases not. Cases without somatic disease, or with minimal somatic findings, occur under diagnoses like burnout, epidemic fatigue, multiple chemical sensitivity, chronic musculoskeletal pain, chronic low back pain, chronic fatigue syndrome, and fibromyalgia. These complaints are particularly common in individuals with low coping and high levels of helplessness and hopelessness. CONCLUSION: The psychobiological mechanisms for this is suggested to be sensitization in neural loops maintained by sustained attention and arousal.

Tveito TH, Hysing M, Eriksen HR. · Department of Biological and Medical Psychology, University of Bergen, Norway. · Occup Med (Lond). · Pubmed #14963248 links to  free full text

Abstract: OBJECTIVE: To assess the effect of controlled workplace interventions on low back pain (LBP) through a review of controlled studies. The rising costs of employees with LBP have resulted in an abundance of offers to society and organizations of interventions to prevent and/or treat the problem. Little is known of the effect of the different interventions. METHODS: A systematic literature search based on the inclusion criteria: controlled trial, work setting and assessment of at least one of the four main outcome measures: sick leave; costs; new episodes of LBP; and pain. Effect of the interventions was reported for the four main outcome measures. RESULTS: Thirty-one publications from 28 interventions were found to comply with the inclusion criteria. Exercise interventions to prevent LBP among employees and interventions to treat employees with LBP have documented an effect on sick leave, costs and new episodes of LBP. Multidisciplinary interventions have documented an effect on the level of pain. CONCLUSIONS: The results show that there is good reason to be careful when considering interventions aiming to prevent LBP among employees. Of all the workplace interventions only exercise and the comprehensive multidisciplinary and treatment interventions have a documented effect on LBP. There is a need for studies employing good methodology.

Magnussen L, Rognsvåg T, Tveito TH, Eriksen HR. · University of Bergen, Norway, Orthopedic University Clinic, Norway, University of Bergen, Norway, & University of Bergen, Norway. · J Health Psychol. · Pubmed #15723893 No free full text.

Abstract: The aim of the study was to evaluate the effect of cognitive intervention (information and physical exercise), on patients with long-lasting back pain referred for surgical evaluation at an orthopaedic hospital, but evaluated as unfit for surgery. One hundred and fifty-two patients were randomized to a five days intervention or control. The intervention had no significant effects on pain. At three-month follow-up, the patients in the intervention group used significantly more active strategies to cope with the back pain compared to the control group. This effect seemed to increase over time, being more pronounced at one-year follow-up evaluation.

Molde Hagen E, Grasdal A, Eriksen HR. · Spine Clinic, Hedmark Central Hospital, 2312 Ottestad, Norway. emhagen@ online.no · Spine (Phila Pa 1976). · Pubmed #14560075 No free full text.

Abstract: STUDY DESIGN: A randomized clinical trial. OBJECTIVES: To evaluate long-term clinical and economical effects of a light mobilization program on the duration of sick leave for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Twelve-month follow-up results from a previous study showed that early intervention with examination at a spine clinic, giving the patients information, reassurance, and encouragement to engage in physical activity as normal as possible had significant effect in reducing sick leave. At 12-month follow-up, 68.4% in the intervention group were off sick leave, as compared with 56.4% in the control group. Patients in this study were followed-up for a period of 3 years to investigate possible long-term effects. MATERIALS AND METHODS: Four hundred fifty-seven patients placed on a sick list for 8 to 12 weeks for low back pain were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic but was treated within the primary health care. RESULTS: Over the 3 years of observation, the intervention group had significantly fewer days of sickness compensation (average 125.7 d/person) than the control group (169.6 d/person). This difference is mainly caused by a more rapid return to work during the first year. There was no significant difference for the second or third year. In particular, there is no increased risk for reoccurrence of illness from early return to work. At 6-month follow-up, patients in the intervention group were less likely to use bed rest and more likely to use stretching and walking to cope with their back pain compared with the control group. This effect diminished. At 12-month follow-up, the only significant difference between the groups was in the use of stretching. Economic returns of the intervention were calculated in terms of increases in the net present value of production for the society because of the reduction in number of days on sick leave. Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately 2,822 dollars per person. CONCLUSIONS: For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years.

Brox JI, Sørensen R, Friis A, Nygaard Ø, Indahl A, Keller A, Ingebrigtsen T, Eriksen HR, Holm I, Koller AK, Riise R, Reikerås O. · Department of Orthopedic Surgery, National Hospital, Oslo, Norway. · Spine (Phila Pa 1976). · Pubmed #12973134 No free full text.

Abstract: STUDY DESIGN: Single blind randomized study. OBJECTIVES: To compare the effectiveness of lumbar instrumented fusion with cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. SUMMARY OF BACKGROUND DATA: To the authors' best knowledge, only one randomized study has evaluated the effectiveness of lumbar fusion. The Swedish Lumbar Spine Study reported that lumbar fusion was better than continuing physiotherapy and care by the family physician. PATIENTS AND METHODS: Sixty-four patients aged 25-60 years with low back pain lasting longer than 1 year and evidence of disc degeneration at L4-L5 and/or L5-S1 at radiographic examination were randomized to either lumbar fusion with posterior transpedicular screws and postoperative physiotherapy, or cognitive intervention and exercises. The cognitive intervention consisted of a lecture to give the patient an understanding that ordinary physical activity would not harm the disc and a recommendation to use the back and bend it. This was reinforced by three daily physical exercise sessions for 3 weeks. The main outcome measure was the Oswestry Disability Index. RESULTS: At the 1-year follow-up visit, 97% of the patients, including 6 patients who had either not attended treatment or changed groups, were examined. The Oswestry Disability Index was significantly reduced from 41 to 26 after surgery, compared with 42 to 30 after cognitive intervention and exercises. The mean difference between groups was 2.3 (-6.7 to 11.4) (P = 0.33). Improvements inback pain, use of analgesics, emotional distress, life satisfaction, and return to work were not different. Fear-avoidance beliefs and fingertip-floor distance were reduced more after nonoperative treatment, and lower limb pain was reduced more after surgery. The success rate according to an independent observer was 70% after surgery and 76% after cognitive intervention and exercises. The early complication rate in the surgical group was 18%. CONCLUSION: The main outcome measure showed equal improvement in patients with chronic low back pain and disc degeneration randomized to cognitive intervention and exercises, or lumbar fusion.

Hagen EM, Eriksen HR, Ursin H. · Spine Clinic, Central Hospital in Hedmark, Ottestad, Norway. · Spine (Phila Pa 1976). · Pubmed #10908942 No free full text.

Abstract: STUDY DESIGN: A controlled randomized clinical trial was performed. OBJECTIVE: To investigate the effect of a light mobilization program on the duration of sick leave for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Early intervention with information, diagnostics, and light mobilization may be a cost-effective method for returning patients quickly to normal activity. In this experiment, patients were referred to a low back pain clinic and given this simple and systematic program as an outpatient treatment. METHODS: In this study, 457 patients sick-listed 8 to 12 weeks for low back pain, as recorded by the National Insurance Offices, were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic, but was treated with conventional primary health care. RESULTS: At 12-month follow-up assessment, 68.4% in the intervention group had returned to full-duty work, as compared with 56.4% in the control group. CONCLUSIONS: Early intervention with examination, information, and recommendations to stay active showed significant effects in reducing sick leave for patients with low back pain.

Lie SA, Eriksen HR, Ursin H, Hagen EM. · Norwegian Network for Back Pain, The Research Unit, Department of Health, University Research Bergen, Bergen, Norway. · Scand J Public Health. · Pubmed #18519297 No free full text.

Abstract: AIMS: Analysing and presenting data on different outcomes after sick-leave is challenging. The use of extended statistical methods supplies additional information and allows further exploitation of data. METHODS: Four hundred and fifty-seven patients, sick-listed for 8-12 weeks for low back pain, were randomized to intervention (n=237) or control (n=220). Outcome was measured as: "sick-listed'', "returned to work'', or "disability pension''. The individuals shifted between the three states between one and 22 times (mean 6.4 times). In a multi-state model, shifting between the states was set up in a transition intensity matrix. The probability of being in any of the states was calculated as a transition probability matrix. The effects of the intervention were modelled using a non-parametric model. RESULTS: There was an effect of the intervention for leaving the state sick-listed and shifting to returned to work (relative risk (RR)=1.27, 95% confidence interval (CI) 1.09- 1.47). The nonparametric estimates showed an effect of the intervention for leaving sick-listed and shifting to returned to work in the first 6 months. We found a protective effect of the intervention for shifting back to sick-listed between 6 and 18 months. The analyses showed that the probability of staying in the state returned to work was not different between the intervention and control groups at the end of the follow-up (3 years). CONCLUSIONS: We demonstrate that these alternative analyses give additional results and increase the strength of the analyses. The simple intervention did not decrease the probability of being on sick-leave in the long term; however, it decreased the time that individuals were on sick-leave.

Magnussen L, Strand LI, Skouen JS, Eriksen HR. · Department of Biological and Medical Psychology, Faculty of Health and Social Science, Bergen University College, Norway. · J Rehabil Med. · Pubmed #17225043 No free full text.

Abstract: OBJECTIVE: To investigate the outcome of a brief vocational-oriented intervention aiming to motivate disability pensioners with back pain to return to work, and to evaluate prognostic factors for having entered a return to work process during the following year. DESIGN: A randomized controlled trial was conducted. SUBJECTS: Participants (n = 89) (mean age 49 years, 65% women) who had received disability pension for more than one year were randomized into an intervention group (education, reassurance, motivation, vocational counselling, n = 45) and a control group (n = 44). METHODS: Primary outcome measures were return to work or having entered a return to work process. Secondary outcome measures were life satisfaction, disability, fear avoidance behaviour and expectancy. RESULTS: The intervention had no statistically significant effect on return to work or having entered a return to work process at 1-year follow-up. Twice as many in the intervention group (n = 10, 22%) had entered a return to work process compared with the controls (n = 5, 11%). The number needed to treat was 9.2 (95% confidence interval (CI) = 3.4, Inf). Only minor differences in secondary outcome measures were demonstrated. Positive expectancy, better physical performance and less pain were related to return to work. CONCLUSION: The effort of returning disability pensioners to work by a brief vocational-oriented intervention may be of clinical relevance. The effect needs to be explored further in larger samples of disability pensioners.

Eriksen HR, Ihlebaek C, Jansen JP, Burdorf A. · Department of Education and Public Health, University of Bergen and Unifob Health, Norway. · Int J Behav Med. · Pubmed #17078768 No free full text.

Abstract: A considerable proportion of sickness absence and disability pension is caused by subjective health complaints, especially low back pain (LBP). In recent years focus has been on psychosocial characteristics of work as potential risk factors. The aim of this study is to examine the relations between psychosocial work aspects and subjective health complaints, LBP, and need for recovery. A total of 779 employees working in home care participated in a cross-sectional study. Higher psychological demands were associated with subjective health complaints and need for recovery. However, decision authority, skill discretion, and the 2 aspects of social support did not seem to be important factors. Higher psychological demands do not seem to be associated with severity of LBP, but does show an association with sick leave.

Ihlebaek C, Brage S, Eriksen HR. · Section of Occupational Health and Social Insurance Medicine, Norwegian Back Pain Network, Research Unit, Unifob helse, University of Oslo, Oslo, Norway. · Occup Med (Lond). · Pubmed #17046991 No free full text.

Abstract: BACKGROUND: From 1996 to 2003, the total number of sickness absence days increased by 65% in Norway. AIM: To investigate if this could be explained by a corresponding increase in the prevalence of self-reported health complaints in the same period. METHODS: Representative samples of the Norwegian working population in 1996 (n = 838) and 2003 (n = 637) answered the subjective health complaints (SHC) questionnaire. The single items of the SHC questionnaire were matched with the corresponding sickness absence statistics from the National Insurance Administration in 1996 and 2003. RESULTS: The main finding was a poor concordance between the change in prevalence of health complaints and the change in the prevalence of sickness absence for diagnoses corresponding to these complaints. The prevalence of health complaints in Norway was high and relatively stable from 1996 to 2003. The only complaints that increased in prevalence during the period were allergy and severe asthma. Sickness absence for health complaints, however, showed a general increase. The diagnoses with the largest percentage increase in sickness absence were sleep problems, tiredness, anxiety and palpitation, although the absolute number of individuals with sickness absence for these complaints was small. CONCLUSIONS: The increased sickness absence in Norway from 1996 to 2003 cannot be explained by an increase in health complaints in the general population in the same period. The increase in sickness absence is most likely to be explained by multifactorial causes, such as changes in working life and health expectations.

Ihlebaek C, Hansson TH, Laerum E, Brage S, Eriksen HR, Holm SH, Svendsrød R, Indahl A. · Norwegian Back Pain Network, Research Unit, HALOS, University of Bergen, Bergen, Norway. · Scand J Public Health. · Pubmed #16990167 No free full text.

Abstract: AIMS: Low back pain (LBP) is a major public health problem in both Norway and Sweden. The aim of the study was to estimate the prevalence of LBP and sickness absence due to LBP in two neighbouring regions in Norway and Sweden. The two areas have similar socioeconomic status, but differ in health benefit systems. METHODS: A representative sample of 1,988 adults in Norway and 2,006 in Sweden completed questionnaires concerning LBP during 1999 and 2000. For this study only individuals in part or full time jobs, (n = 1,158 in Norway and n = 1,129 in Sweden) were included. RESULTS: In Norway the lifetime prevalence was 60.7% and in Sweden 69.6%, the one-year prevalence was 40.5% and 47.2%, and the point prevalence 13.4% and 18.2% respectively. There was a significantly higher risk of reporting LBP in Sweden, even after controlling for gender, age, education, and physical workload. There was no difference in risk of self-certified short-term sickness absence (1-3 days), but it was a 40% lower risk of sickness absence with medical sickness certification in Sweden compared with Norway. CONCLUSION: The prevalence of LBP was higher in the Swedish area than in the Norwegian. The risk of self-certified sickness absence, however, showed no differences and the risk of medically certified sickness absence was lower in the Swedish area. This contradiction might partly be explained by the economical "disincentives" in the Swedish health compensation system.

Hagen EM, Svensen E, Eriksen HR, Ihlebaek CM, Ursin H. · Spine Clinic, Sykehuset Innlandet HF, Ottestad, Norway. · Spine (Phila Pa 1976). · Pubmed #16741460 No free full text.

Abstract: STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare subjective health complaints in subacute patients with low back pain with reference values from a Norwegian normal population. SUMMARY OF BACKGROUND DATA: Comorbidity is common with nonspecific low back pain. We wanted to investigate if these complaints were specific or part of a more general unspecific condition comparable to subjective health complaints in the normal population. MATERIALS AND METHODS: The study group consisted of 457 patients sick-listed 8 to 12 weeks for low back pain. All subjects filled out questionnaires. The subjective health complaints in the study group were compared with reference values from a Norwegian normal population using logistic regression analysis. RESULTS: Compared with the normal reference population, the patients with low back pain had significantly more low back pain, neck pain, upper back pain, pain in the feet during exercise, headache, migraine, sleep problems, flushes/heat sensations, anxiety, and sadness/depression. The prevalence of pain in arms, pain in shoulders, and tiredness was also high, but not significantly higher than in the reference population. CONCLUSIONS: Our findings indicate that patients with low back pain suffer from what may be referred to as a "syndrome," consisting of muscle pain located to the whole spine as well as to legs and head, and accompanying sleep problems, anxiety, and sadness/depression.

Hagen EM, Svensen E, Eriksen HR. · Spine Clinic, Sykehuset Innlandet HF, Ottestad, Norway. · Spine (Phila Pa 1976). · Pubmed #16371893 No free full text.

Abstract: STUDY DESIGN: Modifying effects in multivariate analyses of a randomized controlled trial. OBJECTIVES: To identify prognostic factors for the effect of a brief intervention ("modifiers") at a spine clinic on return to work in patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: A previous study of a brief intervention showed significant reduction of sick leave, compared with usual primary healthcare treatment. Randomized controlled trials give data only on the group as an average. Identifying prognostic factors that interact with the treatment ("modifiers") may identify specific groups requiring this or other types of treatment. METHODS: A total of 457 patients who had been sick-listed 8 to 12 weeks for low back pain were randomized into an intervention group (spine clinic with medical examination, information, reassurance, encouragement to engage in physical activity, n = 237), and a control group (primary health care, n = 220). All subjects filled out questionnaires. Logistic regression and tests for interaction were used to identify prognostic factors and modifiers for return to work in the two groups, at 3 and 12 months of follow-up. RESULTS: At 3 months of follow-up, the strongest modifying effect on return to work was the perception of constant back strain when working and beliefs about reduced ability to work. At 12 months, gastrointestinal complaints were the strongest modifier for the effect of the intervention. CONCLUSION: The spine clinic intervention seems to have a main effect on work absenteeism via interacting with the concerns of being unable to work.

Ihlebaek C, Eriksen HR. · The Research Unit, The Norwegian Back Pain Network, HALOS, University of Bergen, Norway. · Scand J Public Health. · Pubmed #16267889 No free full text.

Abstract: AIM: Deyo's seven "myths" about back pain are based on common misconceptions of causality and therapy of back pain. These myths were alive in the Norwegian population in 2001; this report investigates whether this is true two years later. METHODS: A representative sample of the Norwegian population in 2003 (n = 1,014) were asked to rate their agreement with the seven myths. RESULTS: There is significantly less acceptance of all myths except "Most back pain is caused by injuries or heavy lifting" in 2003. Myths concerning the use and importance of X-ray were still common: 43% agreed that "X-ray and newer imaging tests can always identify the cause of pain" and 50% that "Everyone with back pain should have a spine X-ray". Low level of education is still associated with high acceptance of the myths, but the changes from 2001 are most pronounced for these groups. CONCLUSION: Perceptions in the general population in Norway are slowly changing to be more in accordance with existing knowledge on accurate behaviour and treatment of back pain. This may be related to introduction of new evidence-based guidelines. The difference between educational groups is reduced, but is still a challenge to health professionals and health authorities.

Ihlebaek C, Eriksen HR. · Norwegian Back Pain Network, Research Unit, Department of Biological and Medical Psychology, University of Bergen, Norway. · Spine (Phila Pa 1976). · Pubmed #15303028 No free full text.

Abstract: BACKGROUND: In 2001, several myths of low back pain still were alive in the general population in Norway, myths that were not in concordance with current guidelines. OBJECTIVES: To investigate perceptions about back pain in Norwegian general practitioners and physiotherapists and to compare these with perceptions in the general population. METHODS: During June 2001, 436 general practitioners (mean age 44.8, range 26-69 years) and 311 physiotherapists (mean age 47.6, range 25-70) were asked to rate their agreement with 7 statements, corresponding to Deyo's 7 myths that formulate 7 common misbeliefs on back pain. The corresponding data from the general population of 807 individuals (mean age 45.5, range 25-70) were sampled during early spring 2001. RESULTS: There were significant differences between the general population, general practitioners, and physiotherapists for all myths, the general population being more likely to agree with all myths. The differences were maintained even after controlling for educational level in the general population. There were no differences between general practitioners and physiotherapists except for the myths "radiographs and newer imaging tests can always identify the cause of pain" and "back pain is usually disabling," whereas general practitioners were less likely to disagree with the myths. Few gender and age differences were found in the professional groups. CONCLUSION: In Norwegian general practitioners and physiotherapists, Deyo's 7 myths mostly seem to be dead and buried. However, it does not seem that this has extended to the public yet, as many myths still are alive in the general population.

Ihlebaek C, Eriksen HR. · The Norwegian Back Pain Network, Department of Biological and Medical Psychology, University of Bergen, Norway. · Scand J Public Health. · Pubmed #14555377 No free full text.

Abstract: AIM: The aim of this study was to examine the perception of low back pain care and consequences according to what Deyo refers to as seven "myths" about back pain, in the Norwegian population. METHODS: In spring 2001, seven questions, corresponding to Deyo's myths, were included in an opinion poll (telephone interviews) of a representative sample (n=1015) of the Norwegian population. RESULTS: In total, 41% of the population held that 'If you have a slipped disc you must have surgery'. Approximately 50% believed that 'X-ray and newer imaging tests can always identify the cause of pain' and 'Most back pain is caused by injury and heavy lifting'. Almost 60% agreed that 'Everyone with back pain should have a spine X-ray'. However, only one-quarter believed that 'If your back hurts, you should take it easy until the pain goes away', and approximately one-fifth believed that 'Back pain is usually disabling'. Only 12% believed that 'Bed rest is the mainstay of therapy'. More individuals in the lower- compared with the higher-educated groups believed in the myths. CONCLUSION: Information concerning current knowledge on healthcare and health consequences of low back pain had reached only a small part of the general population. The most important factor for lack of knowledge was education. Developing effective methods to promote adequate self-care and treatment and reduce the risk of chronicity of low back pain in the lower-educated groups should be a top priority.

Tveito TH, Eriksen HR. · No affiliation provided · BMJ. · Pubmed #15775015 links to  free full text

This publication has no abstract.

Eriksen HR, Ursin H. · No affiliation provided · Spine (Phila Pa 1976). · Pubmed #10647172 No free full text.

This publication has no abstract.