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Considerations in physical therapy management of a non-responding patient with low back pain

MADSON TJ
PHYSIOTHER THEORY PRACT , 2017, vol. 33, n° 9, p. 743-750
Doc n°: 186368
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1080/09593985.2017.1331480
Descripteurs : CE51 - LOMBALGIE

Low back pain is a common
condition managed by physical therapists (PT). Screening tools have been
developed to assist the PT with medical screening of patients for serious
disease. Sinister pathologies may present as musculoskeletal symptoms during the
patient examination. It is important for the PT to frequently reevaluate their
patient's response to therapeutic interventions and refer for further evaluation
if they are not responding to conservative care. CASE DESCRIPTION: This case
reports on the history and examination findings of a 36-year-old male presenting
with recurrent low back pain. An emphasis is placed on the therapist's
understanding and use of screening tools when interviewing patients and
determining when medical referral may be indicated based on the patients history
and examination findings. A review of the evidence on the diagnostic accuracy of
screening strategies for malignancy in patients presenting with low back pain is
presented. CONCLUSION: Sinister causes for low back pain are extremely rare. It
is important that PTs be familiar with specific signs and symptoms that may
indicate serious pathology when evaluating patients with low back pain.
Identification of two red flags from this patient's history leads the clinician
to refer the patient back to their primary care provider (PCP) for further
investigation. They included: 1) the patient's inability to improve after one
month and 2) clinicians' judgment. Use of "clinical judgment" may assist the PT
in determining if their patient needs further investigation.

Langue : ANGLAIS

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