Screening
Red Flags/ specific pathology assessment and profile risk of developing persistent and disabling pain.
The diagnosis of low back pain can be difficult to be defined. Most of the patients with low back pain don't have an anatomic or physiological explanation for their symptoms and about 90% of these patients are diagnosed with nonspecific low back pain or other diagnosis based on the exclusion of a specific pathology. In this way, the initial screening should be centered at the evaluation of red flags/ specific pathology.
|
1) |
Simple questions can be used to exclude specific pathologies such as osteoporotic fracture, lumbar canal stenosis, visceral disease, tumor or tumor metastasis, spondyloarthritis and infection. |
|
2) |
The exclusion of radiculopathy associated with low back pain should also be part of the initial screening. |
|
3) |
In case of any doubt about specific pathology / radiculopathy, the patient should be referred to the specialist physician, or additional information (e.g. diagnostic aids) should be investigated. |
Early identification of subgroups of patients with good prognosis and with a high risk of developing persistent and disabling pain is crucial for the implementation of the recommended treatment for non-specific low back pain patients. This will improve health outcomes and reduce costs associated with inappropriate and costly care.
|
1) |
The risk of developing persistent and disabling pain should be assessed by applying the questionnaire “Start Back Screening Tool” (in Portugal, it should be used the Portuguese version of the questionnaire). |
|
2) |
After passing through the categorization of risk, the patient should be immediately referred for the specialized Physiotherapy treatment. |
|
3) |
The patient should have a differentiated and personalized Physiotherapy treatment, according to the risk classification identified in the previous assessment (low, medium or high risk of developing persistent and disabling low back pain). |
