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Social Determinants of Health and Low Back Pain

Teaser: 

1Ted Findlay, DO, CCFP, FCFP, 2Dr. Eugene Wai, MD, MSc, CIP, FRCSC,

1Medical Staff, Calgary Chronic Pain Centre at Alberta Health Services, Calgary, Alberta. 2Associate Professor, University of Ottawa Division of Orthopaedic Surgery, Cross Appointment to School of Epidemiology and Public Health, Ottawa, ON.

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Abstract: It has long been recognized that, following an intervention, two patients with very similar or even identical pathophysiology can have dramatically different outcomes. There is increasing recognition of the role and importance of the social determinants of health as a factor in explaining these differences. This article reviews a number of recent studies that explain the impact of these social determinants, specifically in chronic pain and low back pain. It includes commonly used screening tools and advice for interventions.
Key Words: Social determinants of health, chronic pain, low back pain, screening, social prescription.

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

www.cfpc.ca/Mainpro_M2

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1. According the World Health Organization, the impact of the social determinants of health on health and illness may outweigh that of health care or lifestyle choices.
2. The social determinants of health identified as being of the most importance specifically for low back pain include education and job position.
3. Most communities across Canada will include a number of resources that can be readily accessed as part of a "Social Prescription".
1. Incorporating social work support at an early stage may have the potential to improve treatment compliance and outcomes for those low back pain patients who have notable challenges related to the social determinants of health.
2. Well validated and easily utilized screening tools already exist for the routine screening of social determinants of health.
3. Sleep disorders are shown to affect nearly half of all people reporting chronic pain, with a bidirectional relationship.
Proper patient selection and pre-operative optimization of all modifiable factors improve outcomes and decrease the possibility of FBSS.
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Related Terms: Back Health, social determinants of health, chronic pain, low back pain, screening, social prescription
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Exercise and Dementia: A Step-by-Step Approach to Prescribing Exercise

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFP, DipSportMed CASEM, FCFP, 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, Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Past Chair Section of General and Family Practice Ontario Medical Association, Bruyere Foundation

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Abstract: Dementia is a threat to the aging population. Although dementia cannot be reversed there is evidence that physical exercise can improve activities of daily living, balance, quality of life, funtion, strength, and mental function through various parameters. This article will focus on aerobic training, resistance training, and flexibility training.
Key Words: dementia, exercise, aerobic training, resistance training, flexibility training, exercise prescription.
Approach to Exercise Prescription includes asking questions during a patient's routine visit.
1. Ask about a patient's level of physical fitness.
2. Review their activities, assessing intensity, duration, and frequency.
3. Develop a fitness goal.
Prescribing exercise to patients with dementia that includes focus on aerobic training, resistance training, and flexibility for the prevention of injuries will help reduce the symptoms of dementia and improve function.
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Related Terms: Sports Medicine, dementia, exercise, aerobic training, resistance training, flexibility training, exercise prescription
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BP Monitoring at Home: No Pressure Patient Education

Teaser: 

Dr. Marina Abdel Malak, MD, CCFP, BSc.N,

is a Family Physician in Mississauga, Ontario. She has served on several committees and groups, including The Primary Care Network and Collaborative Mental Health Network. She has a passion for medical education, patient empowerment, and increasing awareness about the relationship between mental, emotional, and physical health. Dr. Abdel Malak is highly involved in quality improvement initiatives, and her research interests include strategies to support physician wellness, patient self-management, and optimizing physician education.

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Abstract: Hypertension is increasingly common—and it is treatable. However, this requires frequent monitoring in order to titre medications, ensure optimal control, and prevent complications. Educating patients on how to monitor their blood pressure at home is central to managing hypertension. This article explores specific advice physicians can give their patients on when and how to monitor their blood pressure at home, and provides resources to use in practice.
Key Words: Hypertension, patient education, monitoring, blood pressure.
1) At-home monitoring by patients has been shown to improve HTN control and prevent complications.
2) Hypertension Canada recommends patients aim to measure their BP about once every month for for one week recording their readings in a log.
3) Patients should check their BP at the same time of day, preferably in the morning after medications, but before consuming alcohol or caffeine, or smoked, or exercised, in the past half hour.
4) Patients need to know what signs and symptoms to report to their physician regarding their BP.
Educating patients on monitoring their BP at-home between their medical visits is crucial.
Lifestyle changes are also important. Physical activity, smoking cessation, and a balanced diet are essential in maintaining BP control.
At every visit, physicians should review monitoring with their patients, lifestyle counselling, and medication adherence.
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Related Terms: Preventive Health, hypertension, patient education, monitoring, blood pressure
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Repetitive Strain Injuries: Featuring Trish the Typist

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

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Abstract: A Repetitive strain injuries are a group of medical conditions that are caused by prolonged repetitive, awkward, or forceful movements that overstress particular muscles, nerves, tendons, or bones. It is most common in the forearms and hands, but can also affect the eyes, neck, shoulders, or back.
Key Words: repetitive strain injuries, good posture, typing technique, regular stretching.
The key to RSI is prevention and that includes the following items:
1. Good Posture: feet flat on the floor, knees at right angles, pelvis rocked forward, lower back slightly arched, upper back naturally rounded, shoulder arms and hands naturally relaxed at the side, head middle of shoulders.
2. Typing technique: wrists straight, let your hands float and your strokes light, and don't strain your fingers for the hard keys like CTRL or ALT.
3. Regular stretching: get up every 15-20 and stretch out your wrists, fingers, elbows, shoulders, neck and upper back.
Repetitive strain injuries are common and can be treated with good posture, proper typing techniques and regular stretching.
Setting up an ergonomic work station at home and taking regular breaks that include strengthening the hands and forearms.
Working with a physiotherapist and/or massage therapist can be helpful in conquering repetitive strain injuries.
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, repetitive strain injuries, good posture, typing technique, regular stretching
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