Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocolReport as inadecuate

Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol - Download this document for free, or read online. Document in PDF available to download.

BMC Musculoskeletal Disorders

, 13:4

First Online: 20 January 2012Received: 16 November 2011Accepted: 20 January 2012


BackgroundLow-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain LBP alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-related leg pain including the group with nerve root pain. This 1 year prospective consultation-based observational cohort study will describe the clinical, imaging, demographic characteristics and health economic outcomes for the whole cohort, will investigate differences and identify prognostic indicators of outcome i.e. change in disability at 12 months, for the whole cohort and, separately, for those classified with and without nerve root pain. In addition, nested qualitative studies will provide insights on the clinical consultation and the impact of diagnosis and treatment on patients- symptom management and illness trajectory.

MethodsAdults aged 18 years and over consulting their General Practitioner GP with LBP and radiating leg pain of any duration at n = 500 GP practices in North Staffordshire and Stoke-on-Trent, UK will be invited to participate. All participants will receive a standardised assessment at the clinic by a study physiotherapist and will be classified according to the clinically determined presence or absence of nerve root pain-involvement. All will undergo a lumbar spine MRI scan. All participants will be managed according to their clinical need. The study outcomes will be measured at 4 and 12 months using postal self-complete questionnaires. Data will also be collected each month using brief postal questionnaires to enable detailed description of the course of low back and leg pain over time. Clinical observations and patient interviews will be used for the qualitative aspects of the study.

DiscussionThis prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients- experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-4 contains supplementary material, which is available to authorized users.

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Author: Kika Konstantinou - Ruth Beardmore - Kate M Dunn - Martyn Lewis - Samantha L Hider - Tom Sanders - Sue Jowett - Simon So


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