MSK TTT 2 October 23, 2013 Dr. Julia Alleyne Focus on Low Back Pain MSK TTT 2 October 23, 2013 Dr. Julia Alleyne

Faculty/Presenter Disclosure Speaker’s Name: Speaker’s Name Relationships with commercial interests: Grants/Research Support: PharmaCorp ABC Speakers Bureau/Honoraria: XYZ Biopharmaceuticals Ltd Consulting Fees: MedX Group Inc. Other: Employee of XYZ Hospital Group Presenters must disclose personal relationships with commercial interests (one slide per faculty member/presenter). Must be presented at all Mainpro+ certified events.

Disclosure of Commercial Support This program has received financial support from [organization name] in the form of [describe support here – e.g. educational grant]. This program has received in-kind support from [organization name] in the form of [describe the support here – e.g. logistical support]. Potential for conflict(s) of interest: [Speaker/Faculty name] has received [payment/funding, etc.] from [organization supporting this program AND/OR organization whose product(s) are being discussed in this program]. [Supporting organization name] [developed/licenses/distributes/benefits from the sale of, etc.] a product that will be discussed in this program: [enter generic and brand name here]. Presenters must outline connections/support for development/presentation of the program from commercial entities or organizations including educational grants, in-kind services (e.g., logistics) AND specific aspects of the faculty/presenter connections that a reasonable program participant might consider relevant to the presentation, (e.g., products made by companies named in Slide 1 that could be germane (relevant/pertinent?) to the presentation). Must be presented at all Mainpro+ certified events.

Mitigating Potential Bias [Explain how potential sources of bias identified in slides 1 and 2 have been mitigated]. Refer to “Quick Tips” document Presenters must outline connections/support for development/presentation of the program from commercial entities or organizations including educational grants, in-kind services (e.g., logistics) AND specific aspects of the faculty/presenter connections that a reasonable program participant might consider relevant to the presentation, (e.g., products made by companies named in Slide 1 that could be germane to the presentation). Must be presented at all Mainpro+ certified events.

What is the Focus ? Global Perspective Review of Tools Integration of Physical Examination Format for Documentation Tools to Teach

#1 All Musculoskeletal Conditions Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4–33% of the population at any given point. Anthony Woolfe Burden of major musculoskeletal conditions Bulletin of the World Health Organization 2003;81:646-6

World Health Organization 2000-2010 Bone and Joint Decade Low back pain is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations. George E. Ehrlich Bulletin of the World Health Organization 2003;81:671-676

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Inflammatory Screen

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Giving Patients Green Light Advice 12/02/11 Giving Patients Green Light Advice 1. Stay Active -Usual Activities 2. Reassurance and Explanation 3. Pain Control 4. Return to Work 5. Ongoing management 17

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Gap Analysis Includes: Lacks

Gap Analysis Includes: Lacks Continuum specific Mechanical approach Key Messages Red Flags Yellow Flags Investigations Referrals Medications Lacks Mechanical approach Clinical Tools Office Strategies Patient Specific Approach

Feedback What about the Physical exam ? How do we document ?

Clinically Organized Relevant Examination CORE Back Tool Clinically Organized Relevant Examination For BACK 25 25

Tools to Teach