A Multidisciplinary Approach to Chronic Low-Back Pain in Western Australia

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Abstract
Patients (50) with chronic low-back pain were subjected to extensive medical, psychiatric and psychosocial assessment by a comprehensive low back pain clinic. Most patients had easily identifiable environmental factors which influenced the persistance of the symptomatology. All patients were significantly functionally impaired, and although neurologic findings were uncovered in only 12 patients, most had restricted movement of the lumbar spine. The initiating cause of the low-back pain was usually from a minor injury or no injury at all. Patients (32) were given psychiatric diagnoses, but only 1 patient was though to warrant psychiatric treatment. While some were considered candidates for limited further conservative treatment, only 2 were subjected to furher surgery (1 fusion, 1 posterior facet rhizotomy). Only 9 were admitted to an inpatient behavior modification program, and the results of this effort were modest. The major benefit was the definitive diagnosis, prognosis, and medical and social planning which was given to all 50 patients upon conclusion of the assessment. The assessment was of benefit to the patient, the referring doctor, the team itself and all other interested parties, such as his family, insurance company and lawyer.

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