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Low Back Pain Objectives and References


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 pain
b. Probing for red flags of potentially serious causes
c. 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 causes
b. 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.
PMID: 23668645
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: Accessed July/19, 2014.
Foundational knowledge
The Calgary Guide - Orthopedics section on Spine Diseases:
Additional resources
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.
PMID: 25030632
Patient information
TOP patient brochure on chronic low back pain:
TOP patient brochure on acute low back pain: