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Certified
for 1 Category 1 AMA Credit
Jointly
Sponsored
by
the
University
of
Alabama
School of
Medicine
Division of Continuing Medical Education and
Alabama Quality Assurance Foundation
| Release
Date: October 19, 2005 |
Expiration
Date: October 19, 2008
|
| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity, physicians and other
healthcare professionals should be able to: |
- Know
when diagnostic tests are appropriate for patients
with back pain
- Recognize
which standard treatments for chronic low back pain
are effective
- Learn
which adjunctive medications may have a role in the
treatment of chronic low back pain
- Recognize
that complimentary modalities may have a role in the
treatment of chronic low back pain
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| Top of Page |
| SOURCE: |
| FACULTY: |
William T. O'Byrne, MD
General Internist
Albuquerque, New Mexico |
| Top of Page |
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| DISCLOSURE: |
The
faculty has no commercial affiliations to disclose.
Because of the nature of preliminary studies, some products
mentioned are unlabeled and investigational. Dosages,
indications, and methods of use of drugs mentioned in
this publication may reflect the experience of the authors,
clinical literature, or other resources. Therefore, please
see the full prescribing information before using any
licensed product mentioned. |
| CME
PARTICIPATION: |
| To participate
in this online course for CME credit, please review
the
objectives before beginning the program. Complete the
course and the self-assessment test before October
19, 2008 to receive CME credit. Your certificate will
then be available online. This process should take
approximately
1 hour. |
| ACCREDITATION: |
|
The University of Alabama
School of Medicine is accredited by the Accreditation
Council for Continuing Medical Education to provide
continuing medical education for physicians.
The University of Alabama
School of Medicine designates this educational activity
for a maximum of 1 Category 1 credit toward the AMA
Physician's Recognition Award. Physicians should
only claim credit commensurate with the extent of
their
participation in the activity.
The boards of nursing
in many states, including Alabama, recognize Category
1 continuing medical education courses as acceptable
activities for the renewal of license to practice
nursing.
|
| DISCLAIMER: |
| Dosages,
indications, and methods of use of any drug referred
to in this publication may reflect the clinical experience
of the authors, clinical literature, or other clinical
resources. Therefore, please see the full prescribing
information before using any product mentioned. UAB
is an equal opportunity/affirmative action institution. |
| INTRODUCTION: |
| Low
back pain is a medical condition that burdens both patients
and physicians. Some series estimate that the annual
prevalence of patients who report some type of low back
pain as high as 20%.[1]
While low back pain affects those of all ages, it appears
to be more prevalent in elderly populations, and results
in the acceleration of functional decline and erosion
in quality of life.[2]
In addition, the financial cost of low back pain is
astronomical and increases annually, and constitutes
on of the most common reasons for doctors visits in
this country.
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| Case
1: |
|
JW
is a 72 year-old male with a past medical history significant
for hypertension and mild chronic obstructive pulmonary
disease. Approximately 3 months go he presented to your
office complaining of severe lower back pain after lifting
some heavy boxes at his home. During that visit, the
patient had limited forward spine flexion, pain on palpation
of the lumbar paraspinous muscles, and a positive right
straight leg raise. The remainder of the physical exam,
including the neurological examination, was within normal
limits. A radiograph of the lumbar spine revealed no
bony abnormalities. You prescribed a short course of
narcotic pain relievers and advised the patient to take
non-steroidal anti-inflammatory drugs (NSAIDS), such
as ibuprofen. You also advised the patient against any
heavy lifting for several weeks, and back rest.
Today, the
patient comes to your office with continued pain in
his lower back. He reports that the NSAIDS helped initially,
but says that their effect has declined with time. He
tells you that he has somewhat more mobility that when
he presented initially. Your exam today reveals decreased
ability to flex the lumbar spine, both antero-posteriorly
and laterally. The straight leg raise is negative bilaterally.
The remainder of the neurological examination is normal
as well.
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