CCFP 105 Topics: Low Back Pain

The GenerEhlist - CCFP Exam Prep, Low Risk Obstetrics & Canadian Primary Care Medicine

Written By: Christopher Clarke, FM PGY2, Victoria BC

Expert Review: Dr Jaques De Jager, GP, CFB Edmonton AB

We are talking Low Back Pain.

Amanda is a 32 year old Search and Rescue Technician with the Royal Canadian Airforce based out of Canadian Forces Base - Comox here on the island. Two days ago, she was on a mission med-evacing a patient from a fishing vessel of the coast.

She and her fellow SAR - Tech were able to stabilize the patient for transport. However, upon bending over to lift the stretcher, Amanda felt an immediate sharp pain her in lumbar spine. Upon returning home for her days off, despite taking Tylenol, which offered little relief, she stayed mainly in bed because the pain was so intense.

She presents to sick parade on Monday at the base clinic, because the pain has not resolved and now she is having some pain radiate down her right leg.

When it comes to back pain, I find it useful to consider timelines as this can help to guide our differential and management.

Definitions

● Acute back pain: 4 weeks

● Subacute back pain: 4-12 weeks

● Chronic back pain: >12 weeks