Factors impacting on doctors' management of acute low back pain: A systematic review

The search generated a total of 28 papers [quantitative (n = 27), qualitative (n = 1) methodologies]. Themes were identified from the accepted papers: education (n = 18), knowledge of clinical guidelines and impact on management (n = 7), and doctors' demographics (n = 4). There was consistent evidence that doctors did not adhere to clinical guidelines when performing a spinal assessment. There was inconsistent evidence that education increased adherence with acute LBP guideline recommendations in terms of referral rates to physiotherapy, for investigations, to secondary care and for maintaining patients at work. Strategies to address the factors impacting on doctors' management of acute LBP are required; these would lead to improvement in patient outcomes and reduce healthcare costs.