Behavior Change Techniques

Abstract

Synonyms Backache; Dorsalgia; Lumbago Definition Pain located between the base of the neck and the gluteal folds that can also be associated with radiating pain in the lower extremities. Description Back pain is one of the most prevalent and costly conditions in the industrialized world. An estimated 80% of individuals will experi-ence back pain at some point in their life. The vast majority of back pain episodes have an unknown etiology and are self-limiting. Approximately 80–90% of cases resolve within the first 6 weeks of onset. The relatively small percentage of individuals who develop chronic back pain (symptoms lasting longer than 3 months), however, account for the majority of the disability expenditures that are associated with this condition. Criteria used to classify back pain are numer-ous and, in certain instances, divergent. For example, the classification of back pain has been based on the duration and location of symp-toms, the underlying spinal pathology, the pres-ence of spinal instability, and the quality of spinal movements. Current biopsychosocial models emphasize the importance of classifying back pain based on the presence of risk factors for severe illness or prolonged disability. A detailed history and physical exam are used to screen for the presence of Red Flags and Yel-low Flags in individuals presenting with acute back pain (less than 6 weeks since the onset of symptoms). Red Flags are signs and symptoms that suggest the possibility of serious pathology, such as carcinoma, immunodeficiency, damage to the spinal cord or cauda equina, and inflam-matory disorders. Red Flags are identified via the following signs and symptoms: a history of severe trauma, significant weight loss, neuro-logical signs and symptoms, severe worsening of pain, and/or systemic illness. Emergency medical attention is required in the relatively rare incidence in which a patient with back pain presents with a Red Flag. In the absence of Red Flags, screening for Yellow Flags is indicated. Yellow Flags are psychosocial signs and symptoms that suggest an elevated risk for prolonged pain and disability. Yellow Flags include: depressed mood, belief that physical activity and pain are damaging, job dissatisfac-tion, and a history of back pain or work disabil-ity.