Case: Eva-May
Investigations: X-rays and spinal imaging tests are not recommended for the routine evaluation, however the back pain has remained for six weeks and you may now consider doing routine lab tests and/or x-rays.
Patient Counseling/Education: Reassurance. Reduce her anxiety, teach her ways she can participate in her care (e.g., exercise, work modification, stress management) and help her to understand the importance of this participation. Encourage her return to work, instruct that she does not have to be totally pain-free.
Activity Modification: Review details of exercise, determine if quotas are realistic, check upon the adequacy of physiotherapy (if ordered). Review work modification.
Medication: Acetaminophen 1,000 mg., 4 times a day. The addition of an NSAID may be considered at this point. Check for adherence.
Return visit: Referral to a specialist, continue to monitor.
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