SIS-09 - A Show of Hands: The Art and Science of Physical Examination Part II: Back and Lower Extremity Pain

Healthcare providers today are usually subject to limitations of time when it comes to the physical evaluation of patients with painful conditions. While it seems easy to label a patient with the diagnosis of headaches or back pain, for example, both general conditions include a significant variability with respect to their underlying etiology and clinical manifestations, which is often even more complicated by overlapping conditions and/or comorbidities. This situation alone calls attention to the need for a highly patient-centered problem-focused examination. While we are all highly trained and skilled providers, there is also a tendency to view the patient from the perspective of our individual training and clinical experience. For a variety of reasons, the art and science of something as simple as “hands-on” examination is deemphasized yet remains while it should be an important component of the clinical evaluation. For something as simple as back pain, there are numerous causes, and seemingly even more treatment options. The question becomes, is there information that can be gleaned from the hands-on examination that can help influence more informed clinical decision making with respect to choosing from the various treatment options?

This session is structured to help provide an interactive hands-on approach with clinical pearls that leverages the multidisciplinary experiences of the presenters in a practical manner to share valuable clinical insights that can help clinically differentiate between conditions that can contribute to back and lower extremity pain. When it comes to back pain alone, there are a number of underling pain generators and each of those can manifest with varying degrees of clinical severity and in a number of different clinical ways. More often than not, multiple pain generators are also present in a single patient making it difficult to differentiate between primary and secondary pain generators.