Back Pain: Laerum E

van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, Koes B, Laerum E, Malmivaara A, Anonymous00002. · No affiliation provided · Eur Spine J. · Pubmed #16550447 No free full text.

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Werner EL, Ihlebaek C, Laerum E, Wormgoor ME, Indahl A. · Department of Public Health and Primary Health Care, University of Bergen, Norway. · Patient Educ Couns. · Pubmed #18242932 No free full text.

Abstract: OBJECTIVE: To evaluate the effect of a media campaign on popular beliefs about LBP, and eventual changes in sick leave, imaging examinations, and surgery. METHODS: Quasi-experimental telephone survey of 1500 randomly chosen people before, during, and after a media campaign in two Norwegian counties, with residents of an adjacent county as the control group. Data on sickness absence, surgery rates for disc herniation and imaging examinations on LBP in the area were collected at the same intervals. RESULTS: The campaign led to a small but statistically significant shift in beliefs about LBP in the general public. In particular, beliefs about the use of X-rays, and the importance of remaining active and at work, seemed to have changed in response to the campaign messages. However, this change in attitude and understanding of the condition did not lead to any corresponding change in sickness behaviour. CONCLUSIONS: Although the media campaign seemed to somewhat improve beliefs about LBP in the general public, the magnitude of this was too small to produce any significant change in behaviour. PRACTICE IMPLICATIONS: A media campaign on LBP should not be limited to small areas and low-budget. A much larger investment is needed for a media campaign to have sufficient impact on public's beliefs on LBP to lead to altered sickness behaviour.

Werner EL, Laerum E, Wormgoor ME, Lindh E, Indahl A. · Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. · Occup Med (Lond). · Pubmed #17916863 No free full text.

Abstract: BACKGROUND: Low back pain (LBP) is among the most frequent causes of sickness absence in Norway, and it is thought that it could be reduced by 30-50% if present day knowledge was implemented in the workplace. Evidence-based interventions in occupational settings to prevent sickness absence are still lacking. AIM: To evaluate whether peer support would be able to modify general beliefs about LBP, pain experiences, health care utilization and sickness absence due to back pain. METHODS: In addition to a media campaign in two Norwegian counties in 2002-05, aiming at improving beliefs about LBP in the general public, the 'Active Back' project trained a peer adviser in six participating workplaces. The task of this peer adviser was to provide information aimed at reducing fear of the pain, supportive advice and arrange for modifications of workloads, etc., for a limited period of time. RESULTS: The prevalence of back pain remained constant throughout the study period, but self-reported intensity of LBP decreased at the end. There was a small decline in use of health care professionals and significant improvements in beliefs, in line with the messages of the campaign. Total sickness absence decreased by 27% and the LBP-related sickness absence by 49%. CONCLUSION: The combination of peer support and modified workload seemed to have additional effects to the general media campaign, and resulted in decline in sickness absence and improvements in beliefs about back pain.

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.

Laerum E, Indahl A, Skouen JS. · Norwegian Back Pain Network, The Communication Unit, Special Hospital for Rehabilitation, Bergen, Norway. · J Rehabil Med. · Pubmed #16801209 No free full text.

Abstract: OBJECTIVE: To identify core elements of what patients with chronic low back pain perceive as good clinical communication and interaction with a specialist ("The Good Back-Consultation"). DESIGN: Qualitative study including observation of consultations and a subsequent patient interview. Quantitative data were also recorded. SUBJECTS: Thirty-five patients with chronic low back pain referred to a specialist. METHODS: Thirty-five consultations were observed with respect to history-taking, clinical examination and interaction between patient and doctor. Patients were subsequently interviewed about how they perceived the consultation. Fourteen specialists with various specialty branches and 35 patients (18 males) participated. For 3 of the specialists a positive effect (return to work) on patients with chronic low back pain had been documented in previous randomized controlled trials. Qualitative data analysis was performed using a template method. RESULTS: Most patients thought that the history-taking and clinical examination had been thorough and satisfactory. Patients emphasized the importance of being given an explanation during the examination of what was being done and found, of receiving understandable information on the causes of the pain, of receiving reassurance, discussing psychosocial issues and discussing what can be done. The most important characteristic of "The Good Back-Consultation" was that the specialist took the patient seriously. CONCLUSION: The findings may represent an important potential for enhancing clinical communication with patients.

Werner EL, Ihlebaek C, Skouen JS, Laerum E. · Department of Research and Development, The Hospital of Rehabilitation, Stavern, Norway. · Spine (Phila Pa 1976). · Pubmed #16094280 No free full text.

Abstract: STUDY DESIGN: A baseline study of the general population and the health care providers in 3 Norwegian counties. OBJECTIVE: To investigate if beliefs about low back pain (LBP) are related to personal experiences and profession sought for care. SUMMARY OF BACKGROUND DATA: Myths about LBP that are abandoned by health professionals are still alive in the public. Such myths represent pain avoidance beliefs and passive coping strategies that may hinder normal spontaneous recovery from an episode of LBP. METHODS: A sample of 1502 randomly selected people was interviewed by telephone, and all the 1105 physicians, physiotherapists, and chiropractors in the area were sent a questionnaire in April 2002. All respondents gave their responses in terms of degree of agreement to 6 statements reflecting beliefs about LBP. RESULTS: Personal back pain experiences were important for beliefs about LBP. People with a history of previous back pain had more faith in the 2 statements "Back pain recovers best by itself" (52.2%) and "In most cases back pain recovers by itself in a couple of weeks" (32.5%) than those with current pain (36.9% and 20.9%, respectively, P < 0.000). There were significant differences in beliefs between physicians and the chiropractors concerning the same 2 statements, and these differences were also reflected in the beliefs of patients treated by the different professional groups. CONCLUSIONS: Belief in spontaneous recovery from LBP seems to be positively correlated to previous experience with LBP without current pain. Patients of the various health care providers seem to have a faith in spontaneous recovery similar to that of their health care provider. These differences may frustrate the public and patients who visit more than one provider, and hinder collaboration among professional groups.

Skouen JS, Laerum E, Jensen TØ. · Nakke- og ryggpoliklinikken, Avdeling for fysikalsk medisin og rehabilitering, Haukeland Universitetssykehus, 5021 Bergen. · Tidsskr Nor Laegeforen. · Pubmed #14600719 links to  free full text

Abstract: Chronic low back pain (LBP) represents a major health problem, especially in Western Europe and North America. The aim of this study is to give an account of why a multidisciplinary treatment program in an outpatient spine clinic is the best treatment for many sub-acute and chronic LBP patients on long-term sick leave. We present an overview of documented treatment effects from multidisciplinary treatment programmes, an outline of the treatment in an outpatient spine clinic, and an account of why multidisciplinary programs are beneficial. The treatment of this patient group is also shown to be cost-effective when one differentiates between light and extensive multidisciplinary programmes. A future challenge rests in the fact that even after optimal treatment, approximately 20 % of patients still do not return to work.

Werner EL, Laerum E, Ihlebaek C. · Nasjonalt Ryggnettverk Formidlingsenheten KGR, Ullevål universitetssykehus 0407 Oslo. · Tidsskr Nor Laegeforen. · Pubmed #12362693 No free full text.

Abstract: BACKGROUND: A great number of patients in general practice suffer from low back pain, and the total cost of this patient population is NOK 15 billion. The aim of this study was to find out how family doctors treat their low back pain patients. MATERIAL AND METHODS: During a two week period in 2001, all family doctors in Aust-Agder county were invited to register all patients suffering from low back pain. They also answered a questionnaire about themselves and their practice. RESULTS: Of the total 80 doctors invited, 53 (66%) recorded their patients, and 48 (60%) also answered the questionnaire. 220 patients were included; i.e. 3.4% of the total number of patients seen in these practices during this period. 81% of the patients underwent clinical examination, 40% were referred to X-ray or CT, 31% to an appropriate specialist, 32% to physiotherapist and 11% to chiropractor. Most of the patients were referred after 12 weeks of pain. 79% of patients received a prescription. Only 24% continued working activity. INTERPRETATION: Most patients in this study receive a medical treatment and a sick leave. More patients are referred to X-ray than what is recommended in the Norwegian guidelines.

Laerum E. · Avdeling for fysikalsk medisin og rehabilitering Ullevål universitetssykehus 0407 Oslo. · Tidsskr Nor Laegeforen. · Pubmed #12092081 No free full text.

This publication has no abstract.

Laerum E. · No affiliation provided · Tidsskr Nor Laegeforen. · Pubmed #10402904 No free full text.

This publication has no abstract.

Brage S, Laerum E. · Institutt for allmennmedisin, Universitetet i Oslo. · Tidsskr Nor Laegeforen. · Pubmed #10385805 No free full text.

Abstract: Low back disorders are prevalent and induce large costs to the health services, the national insurance system and employers. This paper describes the prevalence of low back pain and low back work disability in the Norwegian population, and the incidence and duration of low back work disability in Aust-Agder county. Data from the Norwegian Health Survey 1995 and the registers of the National Insurance Administration are presented. 45% of women and 38% of men reported low back pain within a 14 day period. The prevalence of low back work disability was 1.9%. Low back disorders caused 13-17% of sickness absence, rehabilitation allowance and disability pensions in 1995. In Aust-Agder, the incidence of sickness absence caused by low back disorders was higher among men. In 16% of persons sick-listed due to low back pain without radiating symptoms, the sickness absence episode lasted for more than seven weeks. When radiating symptoms were present, the corresponding figure was 35%. The number of persons with low back disorders with radiating symptoms seems to have increased the most. Further research, preventive measures and guidelines for clinical work should focus on the group of persons who develop chronic low back work disability.

Laerum E, Storheim K, Brox JI. · No affiliation provided · Tidsskr Nor Laegeforen. · Pubmed #17952159 links to  free full text

This publication has no abstract.