Module 10: Prevention and Rehabilitation of Low Back Pain as a Chronic Condition Flashcards
what is non - specific low back pain defined as?
- pain localized between the costal margin and inferior gluteal folds, with or without referred leg pain
what does non - specific LBP have to be absent of ?
- any serious or major pathology (fractures, dislocations, inflammatory arthritides, malignancies)
what is included with LBP?
- inflammation, injury, or compression of spinal nerve roots
- pain, weakness, or numbness
- may be attributed to spinal stenosis (narrowing of spinal canal) or lumbar disc herniation (displacement of disc)
What is difference between acute and chronic low back pain?
- acute: < 3 months since onset
- chronic: > 3 months since onset
what is the epidemiology of low back pain?
- LBP is a common condition globally
- highest prevalence among those aged 40 - 80 years
- may be attributed to traffic
What is the epidemiology of low back pain globally?
- lifetime prevalence of approximately 80%
- global 1 - month prevalence of 23%
- 1 in every 5 Canadians has LBP at any given time
Why is low back pain a burden?
- associated with high health care use and costs
Why is low back pain associated with high health care use and costs?
- most common reason for seeking health care among all musculoskeletal conditions
- 5th most common reason for all physician visits in US
How else is low back pain a burden?
- LBP is leading cause of years lived with disability globally
What are the 4 subthemes under the main theme “Living a life full of pain” for the study of chronic LBP?
- pain is relentless and constantly monitored
- to live with pain is to live by pacing day and night
- pain creates limits that can be tested or obeyed
- manipulating space around me to accommodate pain
What prognostic factors may suggest risk for delayed recovery?
- depression
- passive coping strategies
- job dissatisfaction
- high disability levels
- disputed compensations claims
- somatization
What principles of LBP are clinical practice guidelines?
- evidence - based medicine and patient centered care
- addresses prevention (of delayed recovery), rehabilitation
- recommendations outlined in care pathway
How should the prevention and rehabilitation be addressed for LBP
- provide care in partnership with the patient/ involve the patient in care planning and decision making
- reassure patients about the benign and self limited nature of their pain
- educate patients about the benefits of being actively engaged and participating in their care plan by remaining active and continuing movements
- emphasize active rather than passive treatments
- deliver time limited care
- do not provide ineffective or experimental treatments
What is the risk factor for cancer?
- history of cancer
- unexplained weight loss
- nocturnal pain
- age > 50
What is the risk factor of vertebral infection?
- fever
- intravenous drug use
- recent infection
