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Low Back Pain and Osteoarthritis (Low Back Pain (Red Flags (Cancer,…
Low Back Pain and Osteoarthritis
Chronic Pain
Pain > 12 weeks
Associated problems
sleep
Fatigue
Depression,anxiety
Difficulty moving
Reduced QOL
Negative changes to brain
Low Back Pain
What is it?
Pain, muscle tension or stiffness localized or radiating into lumbar or sacroiliac region (w or w/o siatica
Nociceptive
Neuropathic
Differential Diagnosis
Idiopathic
70%
Mechanical
27%
Referred pain
2%
Non-mechanical
1%
Red Flags
Cancer
Infection
Cauda Equina
Fracture
Ankylosing spondylitis
Treatment
Non-Pharm
Heat
Massage, acupuncture, spinal manipulation
Pharmacologic
NSAIDs
Naproxen
Skeletal muscle relaxants
Antispasmodic
Cyclobenzaprine
Carisoprodol
Metaxolone
Diazepam
Tizanidine
Antispastic
Baclofen
Dantrolene
Diazepam
Tizanidine
For acute use
Pain lasting less than 4 weeks
SEs
Sedation
dizziness
Confusion
Sometimes result in abuse/dependence
Chronic LBP
Non-pharm
Exercise
Rehab
Acupuncture
Stress reduction
Yoga
Pharm
First Line
NSAIDs
Secondary
Duloxetine
Tramadol
Pain lasting greater than 12 weeks
Osteoarthritis
Hand
Knee
Hip