Exam (elaborations)
Osce- low back pain
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A step by step detailed guide on answering OSCE station specific to a patient with low back pain, considering the differentials and scoring those extra points.
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Low back pain1) appropriate introduction- full name and role
2) explains purpose of interview
3) enquires into presenting complaint e.g. site, duration and radiation
4) precipitating, aggrevating, and relieving factors
5) past treatments and results
6) ask about associated health factors, work related stress, social and economic
factors
7) elicit patients concerns and responds sensitively
8) appropriate questioning technique
9) avoid or explains jargon
10) summarises history back to patient including concerns
11) systematic organised approach
12) makes a reasonable attempt at the diagnosis
Pattern, intensity, and duration, nature, and history of onset of the current episode of low
back pain
Any congenital spinal problems
Any type of arthritis in your spine.
Previous episodes of low back pain and treatment.
Previous accidents or injuries involving the back.
Family history of low back pain.
Work history.
Sports and other leisure activities.
Any change in bladder or bowel is effected (rule out cauda quina compression)
Any limb weakness
History of cancer and other illnesses, such as abdominal disease, pelvic disease, or
osteoporosis.
Recent fever or unexplained weight loss.
Corticosteroid use.
Smoking history.
Depresssion questions to see how the pain is affecting the patient’s life. Ask them to rate
their job satisfaction, support system at home and work.
For low back pain it is not uncommon for pain to travel down leg e.g sciatica accompanied by nerve
root signs.
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