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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