Michael Von Korff, ScD; James C. Moore, PhD
Von Korff M, Moore JC. Stepped Care for Back Pain: Activating Approaches for Primary Care. Ann Intern Med. 2001;134:911-917. doi: 10.7326/0003-4819-134-9_Part_2-200105011-00016
Download citation file:
Published: Ann Intern Med. 2001;134(9_Part_2):911-917.
Interventions that encourage return to normal function and reduce fear of physical activity have been shown to improve outcomes for patients with back pain, but routine medical care for back pain often does not provide such interventions. This paper proposes a stepped-care approach that addresses the functional outcomes of back pain. Step 1, which is relevant to most patients, addresses the common fears of patients with back pain and encourages patients to resume normal activities. Step 2, which targets the substantial minority of patients who require more than simple advice to resume activities, provides brief, structured interventions that support physical exercise and return to normal activities. Step 3 targets patients who require more intensive interventions, including treatment of psychological illness when present, before they can return to normal activities in work and family life. Patient needs relevant to these three levels of care are delineated. This stepped-care approach provides a framework for sequencing progressively more intensive interventions and coordinating the efforts of primary care physicians, allied health professionals, behavioral health clinicians, and patients to improve functional outcomes in patients with back pain.
Learn more about subscription options.
Register Now for a free account.
Rheumatology, Back Pain.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only