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17
707

Back Pain

A short presentation looking at the epidemiology, pathology and treatment of back pain.  
James Harper
about 10 years ago
12
1
43

MTPB3 2007 | Case 04 presented by Philip Glynn, MD

www.MeetTheProfessors.com – Case from the practice of Philip Glynn, MD; 76-year-old widow in otherwise good health presented with back pain and a large breast mass causing skin contracture and erosion presented to Drs Cobleigh, Holmes  
Dr Neil Love
about 8 years ago
Preview
0
11

A weekend of back pain

Medical Protection Society Website  
medicalprotection.org
over 4 years ago
Preview
0
7

Back with back pain

Medical Protection Society Website  
medicalprotection.org
over 4 years ago
Preview
3
26

Mechanical Back Pain

 
almostadoctor.com - free medical student revision notes
over 4 years ago
Www.bmj
1
18

A man with a palpable abdominal mass and night sweats

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  
bmj.com
over 4 years ago
Www.bmj
1
10

A man with a palpable abdominal mass and night sweats

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  
bmj.com
over 4 years ago
Preview
2
131

Low Back Pain Lumbar Disc Herniation - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing low back pain. Lumbar disc herniation. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: htt...  
YouTube
over 4 years ago
Preview
2
23

Lumbosacral Disc Herniation ,low back pain- Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing Lumbosacral Disc herniation. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitt...  
YouTube
over 4 years ago
Static.www.bmj
1
12

Opioids for low back pain

Back pain affects most adults, causes disability for some, and is a common reason for seeking healthcare. In the United States, opioid prescription for low back pain has increased, and opioids are now the most commonly prescribed drug class. More than half of regular opioid users report back pain. Rates of opioid prescribing in the US and Canada are two to three times higher than in most European countries. The analgesic efficacy of opioids for acute back pain is inferred from evidence in other acute pain conditions. Opioids do not seem to expedite return to work in injured workers or improve functional outcomes of acute back pain in primary care. For chronic back pain, systematic reviews find scant evidence of efficacy. Randomized controlled trials have high dropout rates, brief duration (four months or less), and highly selected patients. Opioids seem to have short term analgesic efficacy for chronic back pain, but benefits for function are less clear. The magnitude of pain relief across chronic non-cancer pain conditions is about 30%. Given the brevity of randomized controlled trials, the long term effectiveness and safety of opioids are unknown. Loss of long term efficacy could result from drug tolerance and emergence of hyperalgesia. Complications of opioid use include addiction and overdose related mortality, which have risen in parallel with prescription rates. Common short term side effects are constipation, nausea, sedation, and increased risk of falls and fractures. Longer term side effects may include depression and sexual dysfunction. Screening for high risk patients, treatment agreements, and urine testing have not reduced overall rates of opioid prescribing, misuse, or overdose. Newer strategies for reducing risks include more selective prescription of opioids and lower doses; use of prescription monitoring programs; avoidance of co-prescription with sedative hypnotics; and reformulations that make drugs more difficult to snort, smoke, or inject.  
bmj.com
almost 4 years ago
Static.www.bmj
1
32

Opioids for low back pain

Back pain affects most adults, causes disability for some, and is a common reason for seeking healthcare. In the United States, opioid prescription for low back pain has increased, and opioids are now the most commonly prescribed drug class. More than half of regular opioid users report back pain. Rates of opioid prescribing in the US and Canada are two to three times higher than in most European countries. The analgesic efficacy of opioids for acute back pain is inferred from evidence in other acute pain conditions. Opioids do not seem to expedite return to work in injured workers or improve functional outcomes of acute back pain in primary care. For chronic back pain, systematic reviews find scant evidence of efficacy. Randomized controlled trials have high dropout rates, brief duration (four months or less), and highly selected patients. Opioids seem to have short term analgesic efficacy for chronic back pain, but benefits for function are less clear. The magnitude of pain relief across chronic non-cancer pain conditions is about 30%. Given the brevity of randomized controlled trials, the long term effectiveness and safety of opioids are unknown. Loss of long term efficacy could result from drug tolerance and emergence of hyperalgesia. Complications of opioid use include addiction and overdose related mortality, which have risen in parallel with prescription rates. Common short term side effects are constipation, nausea, sedation, and increased risk of falls and fractures. Longer term side effects may include depression and sexual dysfunction. Screening for high risk patients, treatment agreements, and urine testing have not reduced overall rates of opioid prescribing, misuse, or overdose. Newer strategies for reducing risks include more selective prescription of opioids and lower doses; use of prescription monitoring programs; avoidance of co-prescription with sedative hypnotics; and reformulations that make drugs more difficult to snort, smoke, or inject.  
bmj.com
over 3 years ago
Www.bmj
1
24

Telling stories with images

This photograph by Mark Bartley of Cambridge University Hospitals NHS Foundation Trust captures an elderly woman with kyphosis. The condition can cause back pain and breathing difficulties and sometimes requires surgical intervention.  
bmj.com
over 3 years ago
Www.bmj
1
10

Another patient with low back pain

A 52 year old man was admitted to our oncology unit owing to the side effects of ongoing chemotherapy; he also gave a 10 day history of back pain. In 2008, after a bowel resection for colonic obstruction, he had been diagnosed with diffuse large B cell lymphoma. This was treated with eight cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) and a complete response was achieved.  
bmj.com
over 3 years ago
Www.bmj
1
24

Telling stories with images

This photograph by Mark Bartley of Cambridge University Hospitals NHS Foundation Trust captures an elderly woman with kyphosis. The condition can cause back pain and breathing difficulties and sometimes requires surgical intervention.  
bmj.com
over 3 years ago
Preview
1
18

Effective treatments for back pain: Kieran O'Sullivan’s practical tips within a guiding framework

Stream Effective treatments for back pain: Kieran O'Sullivan’s practical tips within a guiding framework by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 3 years ago
Foo20151013 2023 s45v8o?1444774247
2
54

Money-back guarantees

Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A few years ago, a package holiday company advertised guaranteed sunny holidays in Queensland (Australia). The deal went something like this: if it rained on a certain percentage of your holiday days, you received a trip refund. An attractive drawcard indeed, but what the company failed to grasp was that the “Sunshine State” is very often anything but sunny. This is especially so where I live, on the somewhat ironically named Sunshine Coast. We had 200 rainy days last year and well over 2 metres of rain, and that was before big floods in January. Unsurprisingly, the guaranteed sunny holiday offer was short-lived. There are some things that really shouldn’t come with guarantees. The weather is one, health is another. Or so I thought… “Those capsules you started me on last month for my nerve pain didn’t work. I tried them for a couple of weeks, but they didn’t do nothin'.” “Perhaps you’d do better on a higher dose.” “Nah, they made me feel kinda dizzy. I’d prefer to get my money back on these ones an’ try somethin’ different.” “I can try you on something else, but there are no refunds available on the ones you’ve already used, I’m afraid.” “But they cost me over 80 dollars!” “Yes, I explained at the time that they are not subsidised by the government.” “But they didn’t work! If I bought a toaster that didn’t work, I’d take it back and get me money back, no problem.” “Medications are not appliances. They don’t work every time, but that doesn’t mean they’re faulty.” “But what about natural products? I order herbs for me prostate and me heart every month and they come with a 100% satisfaction guarantee. You doctors say those things don’t really work so how come the sellers are willing to put their money where their mouths are?” He decided to try a “natural” treatment next, confident of its likely effectiveness thanks to the satisfaction guarantee offered. Last week I had a 38-year-old female requesting a medical certificate stating that her back pain was no better. The reason? She planned to take it to her physiotherapist and request a refund because the treatment hadn’t helped. Like the afflicted patient above, she didn’t accept that health-related products and services weren’t “cure guaranteed”. “My thigh sculptor machine promised visible results in 60 days or my money back. Why aren’t physios held accountable too?” Upon a quick Google search, I found that many “natural health” companies offer money-back guarantees, as do companies peddling skin products and gimmicky home exercise equipment. I even found a site offering guaranteed homeopathic immunisation. Hmmm… In an information-rich, high-tech world, we are becoming less and less tolerant of uncertainty. Society wants perfect, predictable results — now! For all its advances, modern medicine cannot provide this and we don’t pretend otherwise. Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A clever marketing ploy that patients seem to be buying into — literally and figuratively. I think we all need to be reminded of Benjamin Franklin’s famous words: “In this world, nothing can be said to be certain except death and taxes.” We can’t really put guarantees on whether it will rain down on our holidays or on our health, and should retain a healthy scepticism towards those who attempt to do so. This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/11/0c070a11.asp Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
over 4 years ago
5
2
16

Back Pain

Ultra-short presentation on abdominal pain. The presentation is only a overview rather than a comprehensive presentation of all the causes of back pain.  
Debkumar Chowdhury
over 3 years ago
Www.bmj
0
6

Teenagers with back pain

Back pain in teenagers is common; characterising the pain and identifying the presence of red flags are vital to ensuring that potentially serious conditions are identified  
feeds.bmj.com
over 3 years ago
Www.bmj
0
9

Back pain in a young adult

Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days. Sign up for a free trial  
feeds.bmj.com
over 3 years ago
Www.bmj
0
11

Back pain in a young adult

A 32 year old man was referred to the emergency department with a one week history of worsening mid-thoracic back pain. The pain radiated bilaterally and he occasionally felt it anteriorly in the chest. It was constant in nature and there were no associated symptoms.  
feeds.bmj.com
over 3 years ago