Frequency of chronic low back pain and its management approach; A cross sectional surveyof doctors across Pakistan

Objective: This survey intends to know the frequency of chronic low back pain and the line of management used by the doctors for managing chronic low back pain. Methods: This was a descriptive and cross sectional study with non-probability convenient sampling. This survey was carried out at different centers across Pakistan from May to July 2016. Inclusion criteria were the doctors who have potential to see more patients of low back pain including general physicians, orthopedician and neurologists. Incomplete Performa were excluded. SPSS version 20.0 was used for data analysis. Results: A significant number of low back pain were presented in this cohort of doctors. First priority in treatment of Chronic Low back pain considered was efficacy 147 (73.5%) of drug. Remaining 17% considered combination of patient compliance, rapid mode of action and efficacy as priority. Most common reason for discontinuation of pain medicine was gastrointestinal disturbance with all different toxicity. First line drug for managing Low back pain in adult was diclofenac sodium and potassium (109 responses) and second choice of drug was gabapentin (91responses).First line of treatment of refractory cases was combination therapy and neuroanalgesic notably gabapentin. Conclusion:The frequency of chronic low back pain presenting to the selected cohort is much higher in this survey. Gabapentin is used as the first line therapy for refractory cases of chronic low back pain. Gabapentin is also found Superior than many other drugs in terms of efficacy. It also carries least side effects.