Factors defining care-seeking in low back pain - A meta-analysis of population based surveys

Manuela L. Ferreira*, Gustavo Machado, Jane Latimer, Christopher G. Maher, Paulo H. Ferreira, Rob J. Smeets

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

158 Citations (Web of Science)


Little is known about factors determining health care-seeking behavior in low back pain. While a number of studies have described general characteristics of health care utilization, only a few have aimed at appropriately assessing determinants of care-seeking in back pain, by comparing seekers and non-seekers. The objective of this systematic review was to identify determinants of health care-seeking in studies with well-defined groups of care-seekers and non-seekers with non-specific low back pain. A search was conducted in Medline, AMED, Cinahl, Web of Science, PsycINFO, National Research Register, Cochrane Library and LILACS looking for population-based surveys of non-specific low back pain patients older than 18 years, published since 1966. To be included in the review, studies needed to report on characteristics of well-defined groups of care-seekers and non-seekers. Methodological quality was assessed using a criteria list based on sampling, response rate, data reproducibility, power calculation and external validity. Risk estimates were expressed as odd ratios (95% confidence intervals). When possible, meta-analyses were performed, using a random effects model. Eleven studies were included in the review. Pooled results show that women are slightly more likely to seek care for their back pain as are patients with a previous history of back pain. Pain intensity was only slightly associated with care-seeking, whereas patients with high levels of disability were nearly eight times more likely to seek care than patients with lower levels of disability.
Original languageEnglish
Pages (from-to)747.e1-747.e7
JournalEuropean Journal of Pain
Issue number7
Publication statusPublished - Aug 2010


  • Health care-seeking behavior
  • Health resources
  • Low back pain
  • Meta-analysis

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