STarT Back
Explore this Section
Explore this Section
Low Risk Consultation
Introduction
Patients in the low risk category can be effectively managed in primary care. The success of this depends on getting a few simple things right from the start.
Key points for success
- Make sure your assessment includes biomedical (physical), psychological (distress) and social (impact) aspects.
- Explicitly enquire about patient concerns and expectations. Be sure to then address these when forming a management plan.
- Use the SB tool to help you identify and tackle psychosocial barriers to recovery.
- Think very carefully before investigating or referring patients with simple low back pain. It rarely is of benefit to anyone.
- Avoid unhelpful diagnostic labels (spondylosis, disc rupture, degeneration).
- Promote self-management as a priority
Content of consultation
- A good history taking for diagnosis and to connect with patient
- Focused clinical examination
- Exclude potential red flags
- Use SB tool to support clinical judgement
- Explanation, re-assurance and dealing with distress
- Optimize pain control but avoid inappropriate medication usage.
- Activity promotion
- Back up your explanation with advice in written or visual forms (links)
- Keep an open mind and review the diagnosis if the back problem is persistent – consider physical, psychological and social aspects.