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Considerations in physical therapy management of a non-responding patient with low back pain

机译：低疼痛疼痛的非响应患者的物理治疗管理的考虑因素

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Study Design: Case Study. Background and Purpose: Low back pain is a common condition managed by physical therapists (PT). Screening tools have been developed to assist the PT with medical screening of patients for serious disease. Sinister pathologies may present as musculoskeletal symptoms during the patient examination. It is important for the PT to frequently reevaluate their patient's response to therapeutic interventions and refer for further evaluation if they are not responding to conservative care. Case Description: This case reports on the history and examination findings of a 36-year-old male presenting with recurrent low back pain. An emphasis is placed on the therapist's understanding and use of screening tools when interviewing patients and determining when medical referral may be indicated based on the patients history and examination findings. A review of the evidence on the diagnostic accuracy of screening strategies for malignancy in patients presenting with low back pain is presented. Conclusion: Sinister causes for low back pain are extremely rare. It is important that PTs be familiar with specific signs and symptoms that may indicate serious pathology when evaluating patients with low back pain. Identification of two red flags from this patient's history leads the clinician to refer the patient back to their primary care provider (PCP) for further investigation. They included: 1) the patient's inability to improve after one month and 2) clinicians' judgment. Use of clinical judgment may assist the PT in determining if their patient needs further investigation.
机译：研究设计：案例研究。背景和目的：低腰疼痛是物理治疗师（PT）管理的常见情况。已经开发出筛选工具以帮助PT与患者的医学筛查进行严重疾病。在患者检查期间，险恶的病理可能呈现为肌肉骨骼症状。对于PT来说，频繁重新评估其患者对治疗干预措施的反应并指代进一步评估，如果他们没有响应保守护理。案例描述：本案例报告了一名36岁男性呈现复发低腰疼痛的历史和考试结果。在采访患者时，将重点放置在治疗师的理解和使用筛选工具时，并根据患者历史和检查结果表明医疗转诊时。介绍了患有低腰疼患者筛查恶性肿瘤筛查策略诊断准确性的证据综述。结论：低腰疼痛的险恶原因极为罕见。重要的是，PTS熟悉在评估腰痛患者时可能表示严重病理的特定迹象和症状。识别来自该患者历史的两个红旗导致临床医生将患者将患者推回他们的初级保健提供者（PCP）以进一步调查。它们包括：1）患者在一个月后的无法改善，2）临床医生的判决。使用临床判断可以帮助PT确定他们的患者是否需要进一步调查。

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