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Parcours de soins pour les lombalgies

Date de la dernière mise à jour : février 2024

Diagnosis for Low Back Pain with Radiculopathy

Clinical Cornerstone:

  • In most cases of acute LBP, symptoms go away on their own and most people will recover well. However, for some people the symptoms will continue and turn into chronic pain.

Negative Prognostic Factors: Associated with a poorer outcome or longer duration of pain and disability. The presence of one or more of these factors does not necessarily mean that a patient will have a poor outcome, but they can be used to guide treatment and set realistic expectations.

 

1. Lifestyle-related factors: Smoking, obesity.

2. Baseline pain intensity: Higher initial pain levels.

3. Belief about pain duration: Patients who believe that their LBP will last a long time.

 

4. Psychological factors: Fear avoidance, anxiety, pessimistic expectations.

5. Younger age: Younger age has been identified as a prognostic variable in some studies.

6. Duration of symptoms: Chronic symptoms (lasting more than 12 weeks).

 

7. Presence of leg pain or sciatica

 

8. Work-related factors: Job dissatisfaction, heavy physical work demands, lack of job flexibility.

 

9. Previous episodes of low back pain

 

10. Depression: Mental health conditions like depression.

11. Functional impairment: Limitations in daily activities due to pain.

Conduct patient assessment

Red flags present

Red flags present

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Refer to appropriate emergency or healthcare provider

Non-specific LBP or LBP with radiculopathy:

  • Education

  • Self-care

  • Exercise

  • Manual therapy

  • Medicines

  • Psychological therapy

  • Social support

  • Mind-body interventions

  • Needling therapies, electrotherapies*

  • Mobility assistive devices

  • Multicomponent biopsychosocial care

  • Topical ceyenne pepper

Additionally for LBP with radiculopathy:

  • Medical/surgical consultations

Other specific LBP:

  • Refer to appropriate emergency or healthcare provider

Major symptom/sign change

Goals not achieved

Re-evaluate

Adjust treatment and management plan or refer

References or links to primary sources

Contact information for further inquiries or feedback

carolina.cancelliere@ontariotechu.ca

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