After diagnostic testing, your patient was diagnosed with low back pain without any specific injury. One of the most important aspects of the care at this point is to create a comprehensive teaching plan. What are the important teaching points you need to consider for the acute care of this individual? And what would you suggest for prevention of potential future injuries?
Acute Care of Low Back Pain
Low back pain affects about 80% of U.S. adults at some point in their lives. A patient diagnosed with lower back pain without any injury needs a comprehensive teaching plan that is based on efficacy and risk-reduction teaching points (Van Middelkoop, Rubinstein, Kuijpers, Verhagen, Ostelo, Koes, van Tulder, 2011). For the acute care of an individual with lower back pain, I would consider the following important teaching points on efficacy and risk-reduction; back extension, back flexion, and general fitness exercises. I would also consider improved back mechanic and ergonomic techniques that include maximizing the efficient use of energy by the patient in performing work (Van Middelkoop, Rubinstein, Kuijpers, Verhagen, Ostelo, Koes, van Tulder, 2011). Besides, I would consider mechanical back supports such as back belts or corsets for the patient and, I would also recommend risk factor modification including reducing obesity and smoking. Exercise is critical in strengthening back extensors and reducing injury risk by increasing back flexibility (Verbeek, Martimo, Karppinen, Kuijer, Viikari‐Juntura, Takala, 2011). In addition, physical exercise improves cardiovascular fitness hence minimizes injury and promotes recovery in case an injury occurs. It also improves mood and pain perception hence, helps to reduce the impact of an injury.
Orthotic devices such as corsets and back belts are important devices for back support that prevent lower back pain and prevent possible back injuries (Van Middelkoop, Rubinstein, Kuijpers, Verhagen, Ostelo, Koes, van Tulder, 2011). Research studies have shown that there is reduced risk of lower back pain prevalence and lower back injury among those using back belts. Epidemiologic evidence posits that several modifiable risk factors such as smoking and obesity predispose individuals to develop low back pain (Roffey, Ashdown, Dornan, Creech, Dagenais, Dent, Wai, 2011). These risk factors exert their influence by increasing individual’s risk of precipitating event or perceiving the event as painful or disabling. Hence, smoking cessation and weight loss for obese persons are significant in reducing and preventing lower back pain.
Roffey, D. M., Ashdown, L. C., Dornan, H. D., Creech, M. J., Dagenais, S., Dent, R. M., & Wai, E. K. (2011). Pilot evaluation of a multidisciplinary, medically supervised, nonsurgical weight loss program on the severity of low back pain in obese adults. The Spine Journal, 11(3), 197-204.
Van Middelkoop, M., Rubinstein, S. M., Kuijpers, T., Verhagen, A. P., Ostelo, R., Koes, B. W., & van Tulder, M. W. (2011). A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal, 20(1), 19-39.
Verbeek, J. H., Martimo, K. P., Karppinen, J., Kuijer, P. P. F., Viikari‐Juntura, E., & Takala, E. P. (2011). Manual material handling advice and assistive devices for preventing and treating back pain in workers. The Cochrane Library.