Lower Back Pain Flashcards
What is the main difference between a fit note and a sick note?
the GP can give the patient advice to help him/her return to work
After how many days of self certification is an employee required to obtain a fit note?
7 days
What does the term hyper vigilance refer to in terms of patients?
a hypervigilant attitude is where the patient is excessively attentive to their symptoms which in turn leads to avoidance behaviour and increased disability
What are the four main aspects to a patients belief about illness?
the nature of the illness, the course of the illness, consequences of that illness on a patients life and work, cure or control
In the fear avoidance model, what are the two patient types and who fares better?
avoiders
confronter - have better prognosis
What symptoms are suggestive of caudal equine?
loss of bladder and bowel control, saddle anaesthesia
What significant symptoms/significant findings may suggest cancer?
new onset pain in patients older than 50 or younger than 20, history of cancer, failure to improve after one month
other symptoms include: weight loss, persistent night pain, pain at multiple sites
What might be co-prescribed with an opiate when treating lower back pain?
a laxative, because opioids can have a constipating effect and straining could exacerbate lower back pain
If lower back pain has failed to settle within 6 weeks, what should the patient now be offered?
acupuncture (10 sessions over 12 weeks) continuing with manual therapies (spinal manipulation and massage) group based exercise class DO NOT -refer to laser therapy -TENS -SSRI's -lumbar supports -injection of therapeutic substances into the back
How long does the acute stage of disability typically last?
0-4 weeks
What percentage of acute attacks of lower back pain settle within 6 weeks?
90%
What is the key to managing lower back pain?
self-management simple analgesia (paracetamol) should be considered first followed by exercise, manual therapy and acupuncture
