The Curbsiders Internal Medicine Podcast

#368 Back Pain Update with Dr. Austin Baraki

Nov 28, 2022
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INSIGHT

Risk Stratify Biomedically And Psychosocially

  • Assess both biomedical and psychosocial drivers for new back pain episodes.
  • Use that combined risk to decide imaging, referral, and intensity of support.
INSIGHT

Most Low Back Pain Is Non-Specific

  • Expect 90–95% of primary care low back pain to be non-specific and without a single identifiable lesion.
  • Counsel patients that imaging often finds age-related changes unrelated to pain.
ADVICE

Use The STarT Back Tool

  • Use the STarT Back nine-question tool to stratify risk into low/medium/high.
  • Refer higher-risk patients earlier for multimodal care like PT and psychological treatments.
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