The GP Show3 Aug 2017

#1 Low Back Pain - Review of the treatment guidelines, differentials and role of imaging

In this episode we will review acute and chronic low back pain. •Overview of assessment of back pain •Quick review of some red flags and yellow flags •Review differential diagnosis in LBP •Review of the evidence for some back imaging •Review of radiation risk of some common imaging •Screening tools for assessing risk of chronicity •Review of management principles •What is self management •Acute vs chronic LBP management •Review of latest guidelines and previous evidence for the 4 Ps (Physical, psychological, pharmacological, procedural) References:

Annals of Internal Medicine, Noninvasive treatments for Acute, Subacute, and Chronic Back Pain, 2017, http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

National Institute for health and care Excellence (2016). Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59]. Retrieved from https://www.nice.org.uk/guidance/ng59

http://clinicalevidence.bmj.com/x/systematic-review/1116/overview.html

http://www.racgp.org.au/your-practice/guidelines/handi/interventions/musculoskeletal/mindfulness-and-cbt-for-chronic-low-back-pain/

http://www.racgp.org.au/your-practice/guidelines/handi/interventions/musculoskeletal/exercise-for-chronic-low-back-pain/

Deyo RA. Real help and red herrings in spinal imaging. N Engl J Med, 2013

https://www.mja.com.au/journal/2011/195/8/back-pain-and-leg-weakness

http://www.bmj.com/content/347/bmj.f7095

http://www.imagingpathways.health.wa.gov.au/radiation/pages/jop_principles.html

https://www.keele.ac.uk/sbst/

http://www.cochrane.org/CD001351/BACK_acupuncture-and-dry-needling-for-low-back-pain

http://www.cochrane.org/CD004059/BACK_prolotherapy-injections-for-chronic-low-back-pain

Bardin, L D, King P, Maher C G. (2017). Diagnostic triage for low back pain: a practical approach for primary care MJA 206 (6) 3 April. O'Sullivan P., Lin I.B. (2014). Acute low back pain. Beyond drug therapies. Pain Management Today; 1(1): 8-13. 15. NSW Agency for Clinical Innovation (2016). Management of people with acute low back pain: model of care. Chatswood; NSW Health. Retrieved from https://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0007/336688/acute-low-back-pain-moc.pdf

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