Low Back Pain Guideline: Screening & History-Taking (Part 2)

Low Back Pain Guideline: Screening & History-Taking (Part 2)

hi and welcome back to physio tutors in part two of this video series I’m going to talk about screening and patient history taking for patients with low back pain according to the guideline of the KDF in 2013 if you haven’t watched part 1 of this video series click right here to get more information about the prognosis and the cause of a specific low back pain for the rest of the people we will talk about screening for red flags if a patient comes to you without a referral from the GP or specialist so what are red flags red flags are patterns of signs and symptoms that may indicate a possible serious specific cause of low back pain so let’s look at a list of possible serious diseases in the lumbar spine so signs and symptoms that could indicate malignity are older than 50 years of age pain that is movement independent nocturnal pain general malaise canson history unexplained weight loss or an elevated erythrocyte sedimentation rate so which signs and symptoms are indicative for osteoporotic vertebral fractures these are recent fractures that are younger than two years ago previous vertebral fractures if your patient is older than 60 years of age a low body weight below 60 kilograms or BMI at lower than 20 an older person that had a hip fracture before the prolonged use of corticosteroids local percussion pain or tenderness and actual pressure in the spinal column and at last marked height reduction or an increased thoracic kyphosis so which signs and symptoms could indicate ankylosing spondylitis also known as best OS disease this could be the onset of back pain in a patient that is younger than 20 years male gender re dose I Clara’s history of unexplained peripheral arthritis or inflammatory bowel disease nocturnal pain and morning stiffness that lasts longer than an hour the pain becomes less when the patient is lying down or when he or she is exercising they usually have a good response to the use of NSAIDs and again the ESR rate is increased so if your patient comes to you with severe pain after low back trauma you could think of a vertebral fracture and at last if your patient is younger than 20 years of age and there is palpable misalignment of the processes spinozzi l4 or l5 you would think of a severe spondylolisthesis if you recognize a pattern or if you have a feeling of uncertainty you should always refer your patient back to the GP or specialist after you’re done with the screening you want to continue with your patient history taking in case of low back pain this is not so much different from other pathologies and you can watch our video on patient history taking in the top right corner as a good starting point the numeric pain rating scale can help you to assess pain the PSC scale assesses the patient’s specific complaints and the Quebec back pain disability scale helps you to evaluate the patient’s functional status you can find links to all of these tools in the description down below in case of recurrent low back pain extra attention should be given to possible underlying causes of recurrence such as changes in workload or pressure of work or activities involving body movements and the duration of the low back pain episode and pain free periods between episodes furthermore ask about implementation of ergonomic recommendations and the patient’s compliance with earlier therapies at last it has to be noted that the guideline does not recommend any specific questionnaire to identify psychosocial impeding factors as often clear cutoff points are lacking okay this was part two about screening and diagnosing of the low back pain guidelines series make sure to click on video number three and as always I hope you liked this video give it a like comment in the section down below if you have any questions subscribe to our Channel and check us out and physio tutors calm this was guy I’ll see you next video bye

2 comments on “Low Back Pain Guideline: Screening & History-Taking (Part 2)

  1. aerine coronel Post author

    hello Kai thank you for this very helpful guidelines…they are very important in my present review table…again thank you very much and more power!


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