Focus on Low Back Pain

MSK TTT 2

October 23, 2013

Dr. Julia Alleyne

What is the Focus ?

• Global Perspective

• Review of Tools

• Integration of Physical Examination

• Format for Documentation

• Tools to Teach

#1 All Musculoskeletal Conditions

Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4–33% of the population at any given point.

Anthony Woolfe

Burden of major musculoskeletal conditionsBulletin of the World Health Organization 2003;81:646-6

World Health Organization

2000-2010 Bone and Joint Decade

Low back pain is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations.

George E. Ehrlich

Bulletin of the World Health Organization 2003;81:671-676

Inflammatory Screen

Giving Patients Green Light Advice

1. Stay Active -Usual Activities

2. Reassurance and Explanation

3. Pain Control

4. Return to Work

5. Ongoing management

Gap Analysis

Includes: Lacks

Gap Analysis

Includes:

Continuum specific

Key Messages

Red Flags

Yellow Flags

Investigations

Referrals

Medications

Lacks • Mechanical approach• Clinical Tools• Office Strategies• Patient Specific

Approach

Feedback

What about the Physical exam ? How do we document ?

CORE Back Tool

22

Tools to Teach