Lecture 7 - Lumbar spine: impairments and management

Question 1

For acute NSLBP what are some treatment options

Answer 1

Advice - reassurance, advice to stay active, discourage bed rest, early return to work

Meds - NSAIDS

Physio - manipulative therapy, mackenzie therapy

self care managment advice

Question 2

What is some of the evidence on paracetamol

Answer 2

ineffective in reducing pain and disability or improving quality of life in pts with LBP
4x more likely to have abnormal results on liver function tests

Question 3

Key Messages for LBP

Answer 3

reassure that back pain is a symptom and that most situations does not indicate serious disease or long term disability

avoid labelling

reassure good natural history

encourage activity, self management

Question 4

What are some examples of language to use when speaking to patients

Answer 4

“back pain does not mean your back is damaged”
“motion is lotion”
“your back gets stronger with movement”
“lets work out a plan to help you help yourself”

Question 5

For chronic LBP, what are some key features of treatment

Answer 5

supervised exercise therapy, 
MDT
manip therapy 
massage
CBT (cognitive behaviour tech) - + reinforcement of behviours

Question 6

What advice should be given to pts with LBP

Answer 6

Low Risk: appropriate levels of activity, return to work, avoid bed rest, address fears, furtehr treatment unneeesary

Med risk: ongoing physio - 30 min sessions up to 6 - advice, early activation, supervised exercise

High risk: ongoing physio - 45 m up to 6 - advice, supervised, CBT, MDT