Physical exams commonly lacking in low back pain care

(HealthDay)—Among adults with low back pain (LBP) visiting a physician, 43 percent report no inspection and 20 percent report no palpation at physician encounters, according to a study published in the Sept. 15 issue of Spine.

Joel Press, M.D., from Northwestern University in Chicago, and colleagues surveyed 295 patients regarding the types of physicians they had seen for LBP within the past year. For each physician encounter, the patients were asked whether or not they had removed their clothes or put on a gown or shorts during the examination (a proxy for inspection) and whether the provider had placed his or her hands on the patient (a proxy for palpation).

The researchers found that, for the 696 physician visits, inspection was performed at 57 percent of the encounters. Orthopedic surgeons had the highest reported rate of inspection (72 percent), while chiropractors inspected 40 percent of the time (the lowest among specialties). At 80 percent of physician encounters, palpation occurred, with chiropractors having the highest rates (94 percent) and neurosurgeons having the lowest (58 percent).

"These numbers reflect a need for improvement among providers who treat patients with LBP," the authors write.

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