Back pain MDT Flashcards
Name some red flags for cauda equina syndrome
Bilateral sciatica, Severe neurological deficit of legs, Urinary incontinence/retention, faecal incontenance, loss of fullness Saddle anaesthesia/paraesthesia, Laxity of anal sphincter
Name some red flags for spinal fractures
Sudden onset of severe central spinal pain, relieved by lying down History of major trauma, Osteoporosis/corticosteroids Structural deformity of spone Point of tenderness on vertebral body
Name some red flags for malignancy (back)
Over 50
Gradual onset
Night pain
Localised spinal tenderness
No symptomatic improvement after 4-6 weeks of conservative low back pain therapy
Unexplained weight loss
Past history of cancer
Name some red flags for infection (back)
Fever
TB or UTIs
Diabetes
History of IV drug use
HIV infection, immunosuppresssants/ immunocompromised
What are yellow flags
Yellow flags are psychosocial factors that increase the risk of developing or perpetuating long-term disability and work loss associated with low back pain.
What is bilateral sciatica a red flag for
Cauda equina syndrome
What is Urinary incontinence/retention a red flag for
Cauda equina syndrome
What is faecal incontinence/loss of sensation of rectal fullness a red flag for
Cauda equina syndrome
What is saddle anaesthesia a red flag for
Cauda equia syndrome
What is sudden onset of severe spinal pain a red flag for
spinal fracture
What is a history of trauma a red flag for
spinal fracture
What is osteoporosis/corticosteroid use a red flag for?
spinal fracture
What is structural deformity of the spine a red flag for?
spinal fracture
What is being aged o50 or over a potential red flag for
malignancy
What is gradual onset a red flag for
malignancy
What is night pain a red flag for
malignancy
What is localised spinal tenderness a red flag for
malignancy
What is unexplained weight loss a red flag for
malignancy
What is a past history of cancer a red flag for
malignancy
What is fever a red flag for
Infection
What is a history of TB or a recent UTI a red flag for?
Infection
What is daibetes a red flag for
Infection
What is IV drug use a red flag for
Infection
What is HIV/Immunosupression a red flag for?
Infection
What are the yellow flags associated with back pain?
Attitudes, beliefs, compensation, diagnosis, emotions, family, work
Which professions make up pain management?
Medical staff, nursing staff, physio staff, psychology staff, occupational therapy staff
What do physiotherapists do
Physiotherapists apply knowledge, skills and judgement to promote health and also to assess and breakdown the barriers that restrict physical function.
What is the boom and bust cycle?
Person has a good day, needs to catch up, leads to them overdoing it, increasing pain. Rests to recover, cycle restarts.
Decreasing overall level of activity
How does graded exercise therapy work
Patient proceeds gradually to get challenged without straining themselves
What is biopsychosocial assessment?
Takes into account biological, psychological, and social factors with regard to health
What counts as biological assessment
Red flags, history, past illnesses, and medication regime
Describe the cognnitive aspects of the biopsychosocial model
Attitudes, beliefs, compensation, diagnosis
Describe the impact of emotion on healthcare
Emotional difficulties like depresssion/anxious states are at higher risk of long term health issues. Previous psychiatric history/current issues
Describe the behavioural impact on healthcare
Changes in social/occupational / physical/sleep activities
WHat is the focus of pain mamnagement
People are not helpless, can take an active approach in helping their pain
What is cognitive behavioural therapy?
relationship between thoughts, feelings, physical state and behaviour , with a focus on identifying and modifying less helpful patterns and developing more adaptive coping skills.
Desctibe the fear avoidance model of chronic pain
Ijury leads to pain epxerience, leading to catastrophising, leading to fear, to avoidance, and then to disuse, depression, disability. Feeds back into pain experience as a cycle
However, the cycle can be broken as from pain expereince is another channel: No fear, leading to confrontation, and recovery
What does ACT therapy stand for
Acceptance and commitment therapy
How does ACT therapy work
Instead of withdrawing and ignoring the issue, ACT is not about reducing pain but proposes awareness and changing relationship with internal experiences.
Enabling someone to do things that matter to them in the presence of adverse experiences
