• Episode 206: Acute Back Pain

  • Mar 3 2025
  • Duración: Menos de 1 minuto
  • Podcast

Episode 206: Acute Back Pain

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  • Resumen

  • We discuss the evaluation of and treatment options for acute back pain.

    Hosts:
    Benjamin Friedman, MD
    Brian Gilberti, MD

    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Acute_Back_Pain.mp3 Download Leave a Comment Tags: Musculoskeletal, Orthopaedics Show Notes **Please fill out this quick survey to help us develop additional resources for our listeners: Core EM Survey** Clinical Evaluation:
    • Primary Goal: Distinguish benign musculoskeletal pain from serious pathology.
    • Red Flags: Look for indicators of spinal infection, spinal bleed, or space-occupying lesions (e.g., tumors, large herniated discs).
    • Assessment: A thorough history and neurological exam (strength testing, gait) is essential.
    • Additional Tools: Use bedside ultrasound for post-void residual assessment in suspected cauda equina syndrome
    Imaging Guidelines:
    • Routine Imaging: Generally not indicated for young, healthy patients without red flags.
    • ACEP Recommendations: Avoid lumbar X-rays in patients under 50 without risk factors, as they do not change management and may increase costs and ED time.
    • Advanced Imaging: Reserve MRI for patients with red flags, neurological deficits, or suspected cauda equina syndrome; CRP may be a part of your calculus when evaluating for infectious causes of back pain
    Treatment Options:
    • Evidence-Based First-Line:
      • NSAIDs offer modest benefit.
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