Practice Management
Back pain seems to trouble a significant percentage of adults, inspiring some to seek medical treatment and options for pain relief. But a new study in BMJ Evidence-Based Medicine suggests that most non-surgical interventions have little or no effect on acute or chronic low back pain. Researchers considered 10 treatments compared with placebo and found that in the 301 trials studied, 90% of treatments were not efficacious and are unlikely to be suitable treatment options …
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Urgent message: Although back pain is often due to benign etiologies, symptoms of progressive pain, weakness, and near syncope in one patient ultimately led to a diagnosis of renal cell carcinoma. Citation: Hamazaspyan A, Kedia A, Weinstock M. Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing. J Urgent Care Med. 2024;18(5): 17-22. Anahit Hamazaspyan DO; Ayush Kedia DO; Michael Weinstock MD Abstract Introduction Back …
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It’s been more than a year since the Centers for Disease Control and Prevention recommended that opioids not be used to treat chronic back pain. Unfortunately, too many prescribers have yet to get the message, according to new data from an NPR-Truven Health Analytics Health Poll. The data, reflecting the experiences of 3,002 patients participating in a telephone survey, show that 40% of the visits to a doctor for low back pain ended with a …
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Urgent message: To better evaluate and treat patients with low back pain, urgent care providers need a good understanding of the anatomy of the back and they must be vigilant for “red flags” that signal a potentially serious condition. SHAILENDRA K. SAXENA, MD, PHD, MIKAYLA SPANGLER, PHARM D, BCPS, and SANJEEV K. SHARMA, MD, MBA Introduction Acute low back pain is a common condition often seen by urgent care providers. An episode of acute low …
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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 …
Read MoreWhen Should Diagnostic Imaging Be Used for Patients With Low-back Pain? Key point: With low-back pain, the risks associated with X-rays and MRIs often outweigh the benefits. Citation: Daily POEM: imaging for low-back pain: rarely indicated, often harmful. Available at: www.essentialevidience- plus.com. These guidelines are based on a systematic review and meta- analysis of research investigating the usefulness of various im- aging studies in patients with low-back pain. Based on a meta- analysis of six …
Read MoreRandomized Controlled Trial of Cephalexin Versus Clindamycin for Uncomplicated Pediatric Skin Infections Key point: When it comes to curing skin infected with MRSA (methicillin-resistant Staphylococcus aureus), timely and proper wound cleaning and draining may be more important than the choice of antibiotic. Citation: Chen AE, Carroll KC, Diener-West M, et al. Pediatrics. 2011;127(3):e573-e580. Researchers originally set out to compare the efficacy of two antibiotics commonly used to treat Staph skin infections, ran- domly giving 191 …
Read MoreDiagnostic Medical Errors: What Goes Wrong and Why Key point: Errors often occur because clinicians don’t consider the diagnosis, test for it, or follow up on abnormal test results. Citation: Schiff GD, Hasan O, Kim S, et al. Diagnostic error in medicine: Analysis of 583 physician-reported errors. Arch Intern Med. 2009; 169: 1881-1887. Autopsy data from the past few decades reveal diagnostic error rates of 10% to 15%, but do not inform us about the …
Read MoreIn each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would live to submit a case for consideration, please w-mail the relevant materials and presenting information to [email protected]. The patient is a 14-year-old boy who presents with low back pain after failing from “a high height” and landing on his feet. Exam is normal except …
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