Adult Low Back Pain

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Source: Institute for Clinical Systems Improvement (ICSI). Adult low back pain. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Sep. 65 p. Adult Low Back Pain For workers' compensation patients, see the Workers' Compensation treatment parameters at: Patient calls/presents with LBP or sciatica/radiculopathy. A Patient education regarding primary prevention, including healthy lifestyle and general aerobic fitness. Emphasis on: *Patient responsibility for good back care. *Workplace ergonomics. *Home self-care treatment. Home self-care treatment program. A Evaluation indicated? A Emergent or urgent? A Improving? Primary care evaluation and x-ray indications. A Is a serious underlying condition revealed? A Consult or refer. A Has the patient failed conservative treatment? *activity modification. *self-care exercises. *pain control treatment. A Acute Low Back Pain. LBP that does NOT radiate past the knee for less than or equal to six weeks. Acute Sciatica. LBP with radiation past the knee for less than or equal to six weeks. Chronic Sciatica. Above symptoms for greater than six weeks. Initiate or continue conservative treatment Continue self-care program. A Improving? Re-evaluate and consider redirection. A Improving? Is pain chronic (greater than 6 weeks) A? Chronic LBP *Comprehensive physical and psychosocial re-evaluation. *Lumbar spine x-rays if indicated. A Chronic Sciatica/Radiculopathy *Comprehensive physical and psychosocial re-evaluation. *MRI or CT lumbar imaging indications when patient is potential surgical candidate. A Active rehabilitation. A MRI/CT correlate with symptoms? Improving? Consider epidural steroid injection prior to surgical intervention. A A = Annotation Discuss options and consider possible surgical or non-surgical back specialist. A Improving? All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.