SPINE - NON TRAUMA + TRAUMA
BACK PAIN
PromptBack pain red flags
ResponseAge of onset <20, >55
Constant, progressive pain not relieved with bedrest
Past history of malignancy
History of ostoporosis/prolonged steroid use
Fisk factors for infection - immunosuppression, recent spinal surgery
Systemically unwell/fever
Unexplained weight loss
Significant neurologic symptoms or signs
Structural deformity
Constant, progressive pain not relieved with bedrest
Past history of malignancy
History of ostoporosis/prolonged steroid use
Fisk factors for infection - immunosuppression, recent spinal surgery
Systemically unwell/fever
Unexplained weight loss
Significant neurologic symptoms or signs
Structural deformity
PromptMisconceptions about recovery in back pain
ResponseInappropriate attitudes/beliefs about back pain - activities are “harmful”
Abnormal pain behaviour with inappropriate reduction in activity levels
Past/recurring history of back pain
Work related problems/workersc comp implications
Previous psychologic/stress problems
Poor coping skills
Lack of social support
Abnormal pain behaviour with inappropriate reduction in activity levels
Past/recurring history of back pain
Work related problems/workersc comp implications
Previous psychologic/stress problems
Poor coping skills
Lack of social support
PromptIndications for MRI on history
ResponseIVDU
Immunosuppression
Foecal incontinence or urinary retention
New LL weakness/paralysis
Immunosuppression
Foecal incontinence or urinary retention
New LL weakness/paralysis
PromptIndications for MRI on examination
ResponseNew motor deficit
New sensory deficit
Asymptomatic urinary retention on bladder scan
Lax anal tone
Fever
New sensory deficit
Asymptomatic urinary retention on bladder scan
Lax anal tone
Fever