Low Back Pain

This systematic review and meta-analysis assesses randomized clinical trials that have evaluated interventions to prevent episodes of low back pain.

It appears that exercise is the best prescription for chronic low back pain. Even patient education alone without exercise is useless (a case of faith without works is dead?), as are lumbar support and shoe insoles.

There is considerable heterogeneity in “red flags” amongst numerous low back pain (LBP) guidelines worldwide.  A “red flags” denotes a finding, which if present,…

Low back pain is arguably the most common musculoskeletal complaint encountered in general practice. As such, it is easy to miss something sinister till it’s too late.
Red flags are alarming symptoms that suggest that it could be something sinister. While there is no universal agreement on what they are, it is important to stay vigilant of the more common ones which have been flagged.

Early referral and diagnosis remains a challenge for many who care for patients with musculoskeletal complaints.  This is especially so in those with chronic low back pain (LBP) and the minority who will have ankylosing spondylitis or axial spondyloarthritis.

As a frontline family doctor seeing tonnes of low back pain on a daily basis, one of the potential “red flags” not to be missed is inflammatory back pain. This may signify spondyloarthritis, infection or malignancy.

Early referral for definitive diagnosis and treatment may prevent functional deterioration and permanent disability.

Arthritis Care & Research Explore this journal > Explore this journal > Accepted Articles Previous article in Accepted Articles: Implementing an Electronic Medical Record-Based Reminder is Not Sufficient to Improve Cardiovascular Risk Screening in Rheumatoid Arthritis Previous article in Accepted Ar…

As a rheumatologist, I find this study particularly disconcerting: 10% of Fibromyalgia patients fulfil ASAS criteria for Axial Spondyloarthritis, while 25% show radiographic features suggestive of AS.

Granted, it’s a small study of 88 patients. But if the results are accurate and representative, we may possibly be misdiagnosing a good proportion of early/mild AS as FM, possibly delaying diagnosis of a “red flag” condition. Conversely, if the results are non-representative, then we may end up over-investigating FM (HLA-B27, MRI), or worse, treating them inappropriately with expensive and potentially hazardous medication (anti-TNFs).

Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis

Internal Medicine Article: Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis