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Nonspecific low back pain - Coggle Diagram
Nonspecific low back pain
Pathology
Can be acute or chronic. Be aware of fear avoidance.
Strong links to bio-psycho-social and stress.
Not attributable to a recognised pathology.
Treatement
Reassurance around prevalence (60-70% WHO).
Pain does not equal tissue damage. Normally improves on its own, can come back in bouts, but there are things that you can do to help with pain.
Promote education and supported self management.
Movement and activity is good.
HEP general strength and stretches around core.
Soft tissue and mobilisations (Does not fix issue, this may give window to be more active).
Objective
Clear hip and thoracic.
Palpate, muscles, SP and TP. Isolated or wide spread pain?
AROM, what is stopping movement?
Complete neuro testing (doesn't take long).
Posture, compensations, abnormalities.
Subjective
There is often strong links to back pain and stress, how do you feel about that?
Red flag check!
Remember to clear CE! If not checking D's + N's justify why in notes.
Get information around previous bouts.
Generalised pain with no recognisable cause.
Research
CSP - Remain active as pain allows, simple pain killers if needed, exercise is the most helpful.
Consensus - Supported self management with HEP. Stay active, exercise changes pain thresholds. Avoids chronic condition. Avoid dependency.
NICE - education and supported self management. Mobilisations and soft tissue only with exercise package.
Outcome measures
AROM
Back pain functional scale.
VAS