BROADCASTS.com

Published: Sept. 25, 2017, 7 a.m.

Solidify your approach to back pain and sciatica with Dr. Chris Miles, Assistant Professor, Family & Community Medicine and Associate Director, Sports Medicine program, Wake Forest Baptist Medical Center. He schools us on red/yellow flags, physical exam maneuvers, when to order imaging, and practical tools and tips for evidence-based management! Correspondent Dr. Shreya Trivedi cohosts!

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Full show notes available at http://thecurbsiders.com/podcast

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Case from Kashlak Memorial: 53 yo M construction worker with a BMI of 29 and PMhx of DM2, HTN, depression presenting with right low back pain. He can't remember any trauma or injury. Denies radiation, no bowel or bladder dysfunction, saddle anesthesia, weakness

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Case from Kashlak Memorial: 48 yo F nurse who has had intermittent back pain for years presented with acute flare after helping lift a patient. The pain similar to previous episodes but more severe and also radiates to her left foot. She has tried naproxen and exercises/mindful stress reduction for months without improvement. It is unbearable for her to work.

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Time Stamps

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00:00 Intro

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02:14 Listener feedback

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03:44 Announcements

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05:14 Picks of the week

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08:20 Millenial learners

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10:40 Topic intro and guest bio

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12:06 Getting to know our guest

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17:30 Clinical case of back pain

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20:18 How to hand sensory deficits

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21:51 Red and yellow flag symptoms

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25:44 How to approach patient with yellow flag symptoms

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28:00 Physical exam for back pain

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30:00 Special testing: Trendelenburg, Slump test, and Straight leg raise

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35:48 Classifying types of back pain and a quick recap of teaching points so far

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39:28 How to manage patient expectations

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40:42 Treatment of non-radicular back pain

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46:33 Home exercises and YouTube training

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49:31 When to follow up after initial treatment trial

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51:35 The patient with severe acute pain

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53:33 Some pearls on muscle relaxants

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55:22 Clinical case and how to treat radicular pain

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59:40 Invasive treatment of back pain

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65:04 Back pain treatments that don\u2019t work

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