Journal of Urgent Care Medicine

‘Take Two Aspirin and Call Me in the Morning’ Doesn’t Cut It for Back Pain

There’s no shortage of patients reporting to urgent care centers with back pain being their chief complaint. A new study published in Annals of the Rheumatic Diseases confirms they’re not likely to get satisfactory relief from nonsteroidal anti-inflammatory drugs (NSAIDs), though. Machado, et al looked at 35 randomized, placebo-controlled trials that compared the efficacy and safety of NSAIDs with placebo for spinal pain. They found that treatment effects met the threshold for clinical importance in …

Back-to-School Shouldn’t Mean Back Pain

If parents bring in young children complaining of acute back pain, try taking a history that might be just a little more detailed than usual before ordering expensive images or referring. Actually, focusing on one specific question might reveal the answer: Did the onset of pain coincide with the start of the school year? If the answer is “yes,” ask for a detailed list of what goes into the child’s backpack every morning, and how …

Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Urgent message: Adolescent patients present to urgent care facilities with unique needs and diagnoses. It is imperative that those who care for them be familiar with some of these diagnoses and keep in mind the importance of obtaining a full and accurate medical history and performing a thorough physical examination. Introduction Adolescent patients can represent unique challenges for health-care providers. In caring for them, providers must work from a broad differential, including diagnoses common to …

Serious Pathology Masquerading as Chronic Back Pain

Urgent message: Do not be fooled by the diagnosis made by clinicians before you. Many seemingly benign symptoms can be harbingers of more serious pathology. JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP Chronic back pain is a common presentation in both the urgent care and emergency department (ED) settings. Care-on-demand providers often find themselves deciding how extensive a workup to do for a patient with acute-on-chronic back pain. After a patient has …

Clinical Challenge: January, 2014

THE CASE The patient, a 53-year-old man, presented with acute back pain after a fall. View the image taken (Figure 1) and consider what your diagnosis would be.

High-Risk Conditions Presenting as Back Pain (Part 4)

Urgent message: Back pain with incontinence and focal neurological changes are red flags for serious conditions. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Low back pain is a common presentation in the urgent care setting and it is important for providers to be aware of signs and symptoms that could indicate a more serious condition than nonspecific muscular pain. Be sure to make a thorough evaluation of your patients and pay …

July/August 2012

High-Risk Conditions Presenting as Back Pain (Part 3)

Urgent Message: Fever plus back pain should alert a provider to a potentially serious condition that warrants further workup. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain and back pain is a very frequent presenting complaint in urgent care medicine. When the back pain is associated with fever of unknown etiology or if it occurs in someone with a history of receiving intravenous (IV) …

May 2012

High-Risk Conditions Presenting as Back Pain (Part 2)

Urgent message: Significant cervical spine injuries are rare in urgent care but missing one can have serious implications for patient and provider. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP In this continuing series on back pain diagnostics in urgent care medicine, we urge providers to carefully consider any high-risk spinal conditions that could be presenting as simple back pain. Although many cases of back pain can be attributed to musculoligamentous injury …