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Virtual Care for Low Back Pain Patients

Teaser: 

Ted Findlay, DO, CCFP, FCFP,1 Dr. Hamilton Hall, MD, FRCSC,2

1 is on Medical Staff with the Calgary Chronic Pain Centre at Alberta Health Services, Calgary Zone in Calgary, Alberta.
2 is a Professor in the Department of Surgery at the University of Toronto. He is the Medical Director, CBI Health Group and Executive Director of the Canadian Spine Society in Toronto, Ontario.

CLINICAL TOOLS

Abstract:The COVID-19 global pandemic has had a rapid and massive impact on health care delivery worldwide. Two of the first public health measures applied in Canada and most other developed nations have been some variety of social distancing and "stay at home" orders, which limit the ability of patients to access non-urgent health care services. Patients with chronic pain including low back pain comprise some of the most disadvantaged populations where ongoing support from their family physician is an essential aspect of management. Virtual patient care has rapidly become one of the primary means to deliver of non-urgent management and is, in many ways, ideally suited for the support of chronic low back pain patients. It will continue to be used not only until face to face appointments are again permitted but may become a permanent feature of continuing care.
Key Words: COVID-19; virtual care; video appointments; low back pain; communication.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
1. Virtual patient care is not a new concept, but its use has been accelerated due to the COVID-19 pandemic.
2. Even pre-dating the COVID-19 pandemic, organized medicine in Canada has come out strongly in favor of the delivery of health care by virtual means.
3. There are many on-line resources that can be accessed by patients to help manage their low back pain during pandemic limitations on direct patient contact.
4. Positive patient identification and documentation of consent are requirements for virtual care delivery.
5. Both the physician and the patient have a role to play in ensuring appropriate privacy for the virtual visit.
Have your patient download and test any required communications software prior to their virtual appointment.
Commercial video communication software can be compliant with provincial personal privacy and information protection laws, check with your provincial medical association and/or provincial College of Physicians and Surgeons to be certain that approved software is being used.
Have the patient perform any required clinical measurements and list current medications and any required refills prior to the start of the virtual appointment.
Make sure that unidentified number call blocking does not prevent the virtual appointment from being completed.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, COVID-19, virtual care, video appointments, low back pain, communication
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Osteoporosis Prevention: What can we tell patients?

Teaser: 

Dr. Marina Abdel Malak

is a Family Medicine Resident at the University of Toronto. She graduated and completed her Bachelor of Science in Nursing and went on to study Medicine. She has a passion for medical education, patient empowerment, and increasing awareness about the relationship between mental, emotional, and physical health.

CLINICAL TOOLS

Abstract:Osteoporosis (OP) is the leading cause of hip fractures in patients. Primary prevention focusses on engaging in strategies that prevent the development of osteoporosis. Physicians often provide health information to patients on how to optimize their overall wellness, and therefore, ought to educate patients on bone health as well. Offering advice on specific interventions that decrease the risk of developing OP is an effective way to engage patients in maintaining peak bone mass. Physicians should counsel patients on key points such as dietary modifications, physical activity, and decreasing the use of alcohol and smoking. Setting mutual goals with patients and ensuring that they understand the positive impact this will have on their health is critical.
Key Words: Osteoporosis, bone health, health promotion, primary prevention, education.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
1) Educating patients about methods to decrease the risk of osteoporosis is a critical role of the physician, as peak bone mass develops in early adulthood
2) CALCIUM (see figure 4) is a mnemonic that can help physicians recall what strategies they can address with patients: calcium/vitamin D intake, aerobic activities, limit alcohol, cut down on smoking, increase balance, use supplements if indicated, and maintain a healthy weight
3) Physicians should provide patients with resources and referrals if appropriate to ensure patients receive adequate information/support in promoting their bone health
Patients should be advised that a vitamin D supplement is required to obtain the 1000-2000 IU daily requirement
A calcium supplement is not always indicated if dietary intake is adequate
Both aerobic and weight-bearing activities are essential for OP prevention
Smoking cessation and limiting alcohol are also factors that impact bone health
Patients should be encouraged to mutually set goals around bone health with their physicians, as this increases the likelihood that their behaviour changes will be successful
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Osteoporosis, osteoporosis, bone health, health promotion, primary prevention, education
Disclaimer: 
Disclaimer at the end of each page

The Non-Operative Management of Scoliosis

Teaser: 

Brett Rocos, BSc (Hons), MB ChB, MD, FRCS (Tr & Orth),

Paediatric Spine Fellow, The Hospital for Sick Children, Toronto, ON.

CLINICAL TOOLS

Abstract:Scoliosis is a common condition that every primary care provider will encounter. There are many treatments available in its management, including observation, physical therapy, pain management strategies, casting, bracing and surgery. In this narrative review, the roles of each of the non-operative strategies in managing adult and paediatric scoliosis are explored, and the evidence supporting each is summarised. Scoliosis affects people at every stage of life, and an understanding of the treatments available will aid in counselling patients and making appropriate referrals.
Key Words: Scoliosis, conservative, paediatric, bracing, physiotherapy, alternative therapies, spine cast.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
• Scoliosis is common
• Most patients require observation only
• Patient information is essential
• Casting and bracing have roles in the growing skeleton only
• Physical therapy has limited evidence in both adult and paediatric deformity
• Alternative therapies have no proven use in the management of scoliosis
The majority of patients with scoliosis can be observed
Reliable patient information is critical
There is limited evidence that physiotherapy is effective, and no evidence that alternative therapies are effective in treating scoliosis
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, Scoliosis, conservative, pediatric, bracing, physiotherapy, alternative therapies, spine cast
Disclaimer: 
Disclaimer at the end of each page

What is Athletic Heart Syndrome?

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFPC, DipSportMed CASEM, FCFCP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

Assistant Professor University of Ottawa Faculty of Medicine, Academic Clinical Professor University of Ottawa Faculty of Nursing Medical Director The Kingsway Health Centre, The Kingsway Travel Clinic, The Kingsway Cosmetic Clinic, Beechwood Medical Cosmetic Physio Pharmacy, Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Vice Chair Section of General and Family Practice Ontario Medical Association, Board Director Eastern Ontario Regional Lab Association, Bruyere Foundation

CLINICAL TOOLS

Abstract: A common term for an enlarged heart that is associated with repeated strenuous exercise is athletic heart syndrome (AHS). This article reviews AHS, other serious conditions that appear similar to AHS, and how to identify a young athlete at risk for sudden cardiac death.
Key Words: athletic heart syndrome, enlarged heart, strenuous exercise, sudden cardiac death.
The changes in heart structure and function seen in athletic heart syndrome would suggest illness if seen in non-athletes.
When abnormalities in heart structure or function are detected in an athlete, it is important to ensure the abnormalities are indeed due solely to exercise conditioning, and not to a cardiac disorder.
Consider a clinical history of drug abuse, the use of anabolic steroids, recent viral infections and very tall athletes with arachnodactily or an arm span greater than their height.
Clinically suspicious athletes need to go for further testing.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Sports Medicine, athletic heart syndrome, enlarged heart, strenuous exercise, sudden cardiac death
Disclaimer: 
Disclaimer at the end of each page