Initial Grading Reminder
Grade 1: Mild pain
Grade 2: Moderate pain; limiting instrumental ADLs
Grade 3: Severe pain; limiting self-care ADLs
Assessment and Grading
Characterize the symptom (onset, pace)
Ask the patient:
When did the symptom start? Has it developed gradually or suddenly?
Grade the symptom
Ask the patient:
How would you rate your back pain: is it mild, moderate, or severe? Do you typically have back pain? If so, how is it worse? Is it limiting your ability to do the things you want to do or take care of yourself? Is it worse in the morning?
Patient Query Regarding Other Symptoms/Red Flags
Ask the patient:
Are you having any trouble moving your bowels or urinating?
Patient Factors to Consider That Affect the Approach to Intervention
Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?
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Click Here for Telephone Triage
Suggested Intervention
Patients with new-onset moderate or worse (or worsening) back pain should be seen.
Patients with any of the red-flag symptoms should be seen immediately.
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Click Here for In-Office Triage
Nursing Assessment of Potential Causes
[tab category='Nephritis' header="Nephritis - Nursing Assessment" tab1='Look' tab2='Listen' tab3='Recognize'][tab category='ArthralgiasArthritis' header="Arthralgias and Arthritis - Nursing Assessment" tab1='Look' tab2='Listen' tab3='Recognize']
Differential Diagnosis
What do you suspect is the cause of the back pain?
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