The epidemiology and medical management of low back pain during ambulatory medical care visits in the United States

Table 4 Medical Management during Patient Visits in which Low Back Pain was the Primary Reason for Seeking Care, 2003–2004 (n = 1,042)*

					Chronicity
	LBP Visits				Acute Problem (Initial Visit)				Chronic Problem (Follow-Up Visit)				Chronic Problem Visits
Medical Management	n	NPE	SE	%	n	NPE	SE	%	n	NPE	SE	%	OR	95% CI
Diagnostic tests
Complete blood count	52	2,663	416	6	12	525	197	5	19	1,165	265	6	1.32	0.52-3.37
Urinalysis	69	3,243	456	8	39	1,754	359	16	10	613	161	3	0.18	0.09-0.37
Radiograph	142	5,602	634	13	57	2,385	406	21	24	830	195	4	0.17	0.09-0.32
Other imaging test†	83	2,434	345	6	24	632	146	6	29	904	191	5	0.83	0.44-1.58
*Any diagnostic test*	926	37,683	2,608	89	244	10,807	809	97	396	15,734	1,419	83	0.14	0.04-0.49
Patient counseling
Diet or nutrition	75	3,335	602	8	15	734	196	7	40	1,688	488	9	1.38	0.58-3.32
Weight reduction	49	2,232	529	5	10	504	183	5	25	1,143	384	6	1.35	0.52-3.49
Exercise	204	8,320	1,070	20	49	2,196	391	20	95	3,979	771	21	1.08	0.63-1.85
Mental health counseling‡	45	1,859	639	4	5	240	124	2	31	1,176	525	6	3.00	0.94-9.61
*Any patient counseling*	513	22,397	2,510	53	119	5,408	563	49	224	10,138	1,956	54	1.21	0.70-2.11
Drugs
Non-narcotic analgesics	58	2,492	431	6	13	669	201	6	29	1,351	301	7	1.20	0.51-2.82
Narcotic analgesics	261	10,503	1,128	25	56	2,385	444	21	141	5,355	758	28	1.44	0.76-2.72
NSAIDs (including antiarthritics)	333	14,237	1,180	34	113	5,497	596	49	128	5,288	667	28	0.40	0.25-0.64
*Any drug*	729	30,523	2,012	72	204	9,746	798	88	316	12,703	1,233	67	0.29	0.13-0.62
Physiotherapy§	179	8,596	2,135	20	32	1,408	325	13	88	4,866	1,887	26	2.38	0.93-6.07
Surgical procedure	59	1,932	407	5	2	51	35	0	27	1,042	304	6	12.62	3.18-50.07
Total	1,042	42,427	3,108	100	253	11,111	798	100	457	18,948	2,154	100		...

Abbreviations: CI, confidence interval; LBP, low back pain; NPE, national population estimate for the two-year interval; NSAID, nonsteroidal anti-inflammatory drug; OR, odds ratio; SE, standard error of the national population estimate.
*Table entries for NPE and SE are in thousands; percentages are based on NPE. NPEs may not be reliable for variables other than any diagnostic test, any patient counseling, any drug, exercise counseling, NSAIDs, and narcotic analgesics because n<30 and/or SE>30% of NPE.
†Excluding mammograms.
‡Including mental health counseling, stress management, or psychotherapy.
§Including spinal manipulation.