Skip to main content

Advertisement

Log in

Reasons for repeated medical visits among patients with chronic back pain

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: This study identifies the key motivations of patients repeatedly seeking medical care for chronic back problems.

DESIGN: We conduced one-on-one, in-depth interviews with patients to discuss their experiences with low back pain and its care. To validate our interpretation of the qualitative data, participants were mailed questionnaires listing the themes identified in the interviews and asked to rate the importance to them of each of the themes.

SETTING: Managed health care plans in Atlanta, Dallas, and Seattle.

PARTICIPANTS: Fifty-four patients (37% male, 63% female) who were 25 to 65 years of age and had three or more medically attended episodes of low back pain during the 3 years preceding the study.

MAIN RESULTS: In describing their motivations for seeking medical care for back pain, nearly all participants cited difficulty in performing normal activities and the desire to discover the cause of the pain. Other motivations for seeking medical care for back pain included increased pain and the desire for a diagnostic test or a new treatment. Many of the verbalized reasons for repeated medical visits among patients with chronic back pain are probably best understood as seeking validation of their suffering.

CONCLUSIONS: Patients with chronic back pain report many unmet needs and expectations. Overall satisfaction might be improved if clinicians elicit patients’ views of underlying causes and their expectations from office visits.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Deyo RA, Yuh-Jane TW. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264–8.

    Article  PubMed  CAS  Google Scholar 

  2. Deyo RA, Cherkin D, Conrad D, Volinn E. Cost, controversy, crisis: low back pain and the health of the public. Annu Rev Public Health. 1991;12:141–56.

    Article  PubMed  CAS  Google Scholar 

  3. Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988;318:291–300.

    Article  PubMed  CAS  Google Scholar 

  4. Cypress BK. Characteristics of physician visits for back symptoms: a national perspective. Am J Public Health. 1983;73:389–95.

    PubMed  CAS  Google Scholar 

  5. Andersson GBJ, Pope MH, Frymoyer JW, Snook S. Epidemiology and cost in occupational low back pain. In: Pope MH, Andersson GBJ, Frymoyer JW, Chaffin DB, eds. Occupational Low Back Pain: Assessment, Treatment and Prevention. St. Louis, Mo: Mosby-Year Book; 1991:95–113.

    Google Scholar 

  6. Deyo RA. Conservative therapy for low back pain: distinguishing useful from useless therapy. JAMA. 1983;250:1057–62.

    Article  PubMed  CAS  Google Scholar 

  7. Spitzer WO, LeBlanc FE, Dupuis M. Scientific approach to the assessment and management of activity-related spinal disorders. A monograph for physicians: report of the Quebec Task Force on Spinal Disorders. Spine. 1987;12(suppl):S1–59.

    Google Scholar 

  8. Cherkin D, Deyo RA, Berg AO. Evaluation of a physician education intervention to improve primary care for low-back pain, II: impact on patients. Spine. 1991;16:1173–8.

    Article  PubMed  CAS  Google Scholar 

  9. Cherkin D, Deyo RA, Berg AO, Bergman JJ, Lishner DM. Evaluation of a physician education intervention to improve primary care for low-back pain, I: impact on physicians. Spine. 1991;16:1168–72.

    Article  PubMed  CAS  Google Scholar 

  10. US Department of Health and Human Services. Acute Low Back Problems in Adults: Clinical Practice Guideline. Washington, DC: US Government Printing Office; 1994. AHCPR publication 95-0642.

    Google Scholar 

  11. Cherkin DC, Deyo RA, Volinn E, Loeser JD. Use of the International Classification of Diseases (ICD-9-CM) to identify hospitalizations for mechanical low back problems in administrative databases. Spine. 1992;17:817–25.

    Article  PubMed  CAS  Google Scholar 

  12. Shekelle PG, Markovich M, Louie R. Factors associated with choosing a chiropractor for episodes of back pain care. Med Care. 1995;33:842–50.

    Article  PubMed  CAS  Google Scholar 

  13. Thomas KB. General practice consultations—is there any point in being positive? BMJ. 1987;294:1200–2.

    Article  PubMed  CAS  Google Scholar 

  14. Bass MJ. The physician’s actions and the outcome of illness in family practice. J Fam Pract. 1986;23:43–7.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Funding for this study was provided by Prudential Health Care.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McPhillips-Tangum, C.A., Cherkin, D.C., Rhodes, L.A. et al. Reasons for repeated medical visits among patients with chronic back pain. J GEN INTERN MED 13, 289–295 (1998). https://doi.org/10.1046/j.1525-1497.1998.00093.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1525-1497.1998.00093.x

Key words

Navigation