1 / 25

History

History. Red Flags for LBP. Name the R ed F lags for LBP?. Red Flags to LBP. Cancer Related Red Flags with Low Back Pain Infection Related Red Flags with Low Back Pain Cauda Equina Syndrome Related Red Flags with Back Pain Significant Herniated nucleus pulposus

thalia
Download Presentation

History

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. History

  2. Red Flags for LBP

  3. Name the Red Flags for LBP?

  4. Red Flags to LBP • Cancer Related Red Flags with Low Back Pain • Infection Related Red Flags with Low Back Pain • CaudaEquina Syndrome Related Red Flags with Back Pain • Significant Herniated nucleus pulposus • Vertebral Fracture related red flags with Low Back Pain • Abdominal Aortic Aneurysm red flags with Low Back Pain

  5. Name the “Red Flags” for Cancer with LBP?

  6. Red Flags: Cancer Related Red Flags with Low Back Pain • A. History of cancer • B. Unexplained weight loss >10 kg within 6 months • C. Age over 50 years or under 17 years old • D. Failure to improve with therapy • E. Pain persists for more than 4 to 6 weeks • F. Night pain or pain at rest • D. Immunocompromised states • 1.Systemic Corticosteroids • 2.Organ transplant • 3.Diabetes Mellitus • 4.Human Immunodeficiency Virus (HIV) • 5.Rest Pain

  7. Name the “Red Flags” for infection related to LBP?

  8. Red Flags: Infection Related Red Flags with Low Back Pain • A. Persistent fever (temperature over 100.4 F) • B. History of intravenous Drug Abuse • C. Recent bacterial infection • 1.Urinary Tract Infection or Pyelonephritis • 2.Cellulitis • 3.Pneumonia

  9. Name the “Red Flags” for caudaequina syndrome for LBP?

  10. Red Flags: CaudaEquina Syndrome Related Red Flags with Back Pain • A. Urinary Incontinence or retention • B. Saddle anesthesia • C. Anal sphincter tone decreased or fecal Incontinence • D. Bilateral lower extremity weakness or numbness • E. Progressive neurologic deficit

  11. Name the “Red Flags” for HNP related to LBP

  12. Red Flags: Significant Herniated nucleus pulposus • A. Major Muscle Weakness (strength 3 of 5 or less) • B. Foot drop

  13. Name the “Red Flags”related to vertebral fracture related to LBP

  14. Red Flags: Vertebral Fracture related red flags with Low Back Pain • A. Prolonged use of Corticosteroids • B. Mild trauma over age 50 years • C. Age greater than 70 years • D. History of Osteoporosis • E. Recent significant trauma at any age • 1.Ejection from motor vehicle • 2.Fall from substantial height

  15. Name the “Red Flags” for AAA for LBP?

  16. Red Flags: Abdominal Aortic Aneurysm red flags with Low Back Pain • A. Abdominal pulsating mass • B. Atherosclerotic vascular disease • C. Pain at rest or nocturnal pain • D. Age greater than 60 years

  17. References • VIII.ReferencesA.Atlas (2001) J Gen Intern Med 16:123 • B.Petri(1999) Emerg Med Clin North Am 17:25-39 • C.Swenson(1999) NeurolClin 17:43-63

  18. Study on Red Flags • Overall, 11 of 1172 (0.9%) patients were confirmed as having a serious spinal condition, including spinal fracture (n = 8), caudaequina syndrome (n = 1), or inflammatory disorder (n = 2). • No patients were identified with cancer or infection as the cause of their pain. • For spinal fractures, the diagnostic accuracy of the following red-flag questions was determined: (1) age > 70 years, (2) significant trauma, (3) prolonged corticosteroid use (duration not defined), and (4) altered sensory level (from the trunk down).

  19. How would you treat?

  20. Thermotherapy

  21. Temperature • Viscosity • NCV – increase with heat • Blood flow – heat increases • Collagen extensibility – heat increases tendon and collagenase activity is increased

  22. Heat uses are • hyperemia • analgesia • hyperthermia • decrease muscle tone • increase in collagen elasticity

  23. Heat Therapy • Chronic • Proximal • Reduce muscle spasms • Pain reduction • Reduce stiffness and contractures • Arthritis • Chronic inflammation

  24. Contraindications to Heat • Ischemia (10% increase in skin temp there is 100% increase in metabolic demand) • Bleeding disorders • Impaired senation • Inability to communicate or respond to pain • Malignancy • Acute trauma or inflammation • Scar formation

  25. Superficial heat

More Related