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Primary Care Research on Low Back Pain: The State of the Science

Cherkin, Daniel C., PhD

Primary Care

The past few years have witnessed an explosion of primary care-relevant research on low back pain. The descriptive studies have helped elucidate the diagnostic and therapeutic interventions that are in current use. The literature syntheses have clarified what is known about the usefulness of these interventions. The randomized trials have pushed the frontiers of knowledge in several important areas. The quality of research in this field is mixed but has improved significantly in recent years. If research is to lead to substantial improvements in primary care for low back pain, however, the focus must be broadened to embrace an existing but neglected paradigm, the biopsychosocial model. It must be understood how the physician can become a more effective healer and counselor for the patient with back pain. This will require that greater attention be paid to literature outside of the field and that communication and collaboration with researchers in other disciplines increase. Modern distractions such as technology, litigation, and disability compensation have interfered with the ability of physicians to meet their patients' needs. If physicians are to become more effective managers of such common problems as low back pain, they must rediscover their ability to help their patients cope with illness and suffering.

From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington.

Presented in part as the keynote lecture at the Second International Forum for Primary Care Research on Low Back Pain on May 30, 1997, The Hague, The Netherlands.

Acknowledgment date: August 11, 1997.

Acceptance date: November 4, 1997.

Device status category: 1.

Address reprint requests to: Daniel C. Cherkin, PhD; Center for Health Studies; Group Health Cooperative of Puget Sound; 1730 Minor Ave. - Suite 1600; Seattle, WA 98101;

© 1998 by Lippincott Williams & Wilkins