By the end of Family Medicine Clerkship, students will be able to:
1. Perform a patient-centered interview that includes:
a. Exploration of different causes of mechanical low back painb. Probing for red flags of potentially serious causesc. Potential psychosocial risk factors for chronic disability (i.e. “yellow flags”)
2. Perform a focused physical exam that distinguishes different causes of mechanical low back pain and identifies signs of potentially serious secondary causes e.g. infection, pathological fracture, non-MSK referred pain
3. Propose initial management plan that includes:
a. Appropriate and timely investigation of urgent potentially serious secondary causesb. Appropriate evidence-informed management of mechanical LBP, including pharmacological and non-pharmacological modalities, return to work, and secondary prevention.
Recommended Resources Addressing the Objectives
Back pain in adults (14 pages, all worth it – Fantastic DDx of back and low-back pain!)
Objectives covered: 1ab, 2, 3ab
Becker JA, Stumbo JR. Back pain in adults. Prim Care 2013 Jun;40(2):271-288.
A Summary of the Guideline for the Evidence-Informed Primary Care Management of Low Back Pain (2 pages)
Objectives covered: 1bc, 3ab
Towards Optimized Practice (TOP). A Summary of the Guideline for the Evidence-Informed Primary Care Management of Low Back Pain. 2011; Available at: http://www.topalbertadoctors.org/download/573/LBPSUMMARYnov24.pdf. Accessed July/19, 2014.
The Calgary Guide – Orthopedics section on Spine Diseases
Top 10 causes of low back pain in family medicine, plus clinical pearls
Objectives covered: 1a
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Low back pain. Can Fam Physician 2007 Jun;53(6):1058.
Low back pain in primary care (6 pages)
Objectives covered: 3a
Deyo RA, Jarvik JG, Chou R. Low back pain in primary care. BMJ 2014 Jul 16;349:g4266.
TOP patient brochure on chronic low back pain
TOP patient brochure on acute low back pain