number 1 cause of years lived w disability
LBP+neck pain
risk factors of LBP
age (older) Gender (F>M) Lower socionomic status genetics puberty smoking alcohol bmi
LBP occupational risk factors
High physical load Low job satisfaction monotonous work awkward postures poor social support compensation schemes high perceived stress + job demands
What are blue flags + ex
- Subjective factors
- Perceptions of heavy work, inability tp modify work, job stress, workplace social support, job satisfaction
What are black flags and ex
Factual factors
-Pay rate, negotiated entitlements, sickness policy, reimbursement rates etc
What is a large negative prognostic factor of LBP
Evidence suggests that fear avoidance beliefs are prognostic for poor outcome in subacute LBP
-Interventions to reduce fear avoidance beliefs, may avoid delayed recovery and chronicity
Indications for advanced imaging in the Lumbar spine
- inf
- tumor
- osteoperosis
- fracture
- functionally sig or progressive neuromuscular deficits
- ankylosing spondylitis
- radicular syndrome
- neurogenic claudication
Acute LBP recomendations
- advice to stay active+ reassurence
- education about LBP
- employ a short course of paracetamol/acetaminophem or NSAIDs
- spinal manip/mobs
- NO bed rest
Chronic lip recomendations
provide advice to stay active + some form of exercise
- perhaps weak opiod meds (preferably NSAIDs)
- spinal manip
LBP w substantial neuro involvement guidlines
- advice to stay active
- reassure + provide education on LBP
- short course paracetamol, acetaminophen, nsaids
- spinal manip
- NO bed rest
- back exercises (no specific type recommended)
What do we know about SMT of LBP
- SMT and mob show clinical efficacy
- supine and side posture lumbar SMT show equivenlent clinical efficacy
- SMT/mob is recommended first line tx for LBP of all durations
- cavitation is indicative of but not necessary for a successful input
What is the strongest predictor of future back pain
prior back pain
