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

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

3. #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

4. 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

11. Inflammatory Screen

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

19. Gap Analysis Includes: Lacks

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

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

22. CORE Back Tool 22

25. Tools to Teach