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Back Pain in EMS, Part 1

Upon conclusion of this course, students will be able to:

  • Understand the scope of the epidemic of back pain among EMS personnel;
  • Articulate the mechanical and biopsychosocial origins of low-back pain;
  • Describe how lifting, posture, and body position can give rise to chronic pain syndromes;
  • Understand the current evidence base surrounding EMS-specific back pain. 
  • References

    1. Suyama J, Rittenberger JC, Patterson PD, Hostler D. Comparison of public safety provider injury rates. Prehosp Emerg Care, 2009; 13(4): 451–5.

    2. Maguire BJ, Hunting KL, Guidotti TL, Smith GS. Occupational injuries among emergency medical services personnel. Prehosp Emerg Care, 2005; 9(4): 405–11.

    3. Studnek JR, Ferketich A, Crawford JM. On the job illness and injury resulting in lost work time among a national cohort of emergency medical services professionals. Am J Industr Med, 2007; 50(12): 921–31.

    4. Reichard AA, Jackson LL. Occupational injuries among emergency responders. Am J Industr Med, 2010; 53(1): 1–11.

    5. Reichard AA, Marsh SM, Tonozzi TR, Konda S, Gormley MA. Occupational Injuries and Exposures among Emergency Medical Services Workers. Prehosp Emerg Care, 2017; 21(4): 420–31.

    6. Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin, 2007; 25(2): 353–71.

    7. Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. New Engl J Med, 1995; 333(14): 913–7.

    8. Menezes Costa LD, Maher CG, Hancock MJ, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ, 2012 Aug 7; 184(11): E613–E624.

    9. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet, 2018; 391(10,137): 2,356–67.

    10. Studnek JR, Crawford JM, Wilkins JR 3rd, Pennell ML. Back problems among emergency medical services professionals: the LEADS health and wellness follow-up study. Am J Industr Med, 2010; 53(1): 12–22.

    11. Lim YZ, Chou L, Au RT, et al. People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: a systematic review. J Physiotherapy, 2019; 65(3): 124–35.

    12. Ferreira G, Traeger AC, Machado G, O’Keeffe M, Maher CG. Credibility, Accuracy, and Comprehensiveness of Internet-Based Information About Low Back Pain: A Systematic Review. J Med Internet Res, 2019; 21(5): e13357.

    13. Thielke S, Sale J, Reid MC. Aging: are these 4 pain myths complicating care? J Fam Pract, 2012; 61(11): 666–70.

    14. Lutz GK, Butzlaff M, Schultz-Venrath U. Looking back on back pain: trial and error of diagnoses in the 20th century. Spine, 2003; 28(16): 1,899–905.

    15. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiology, 2015; 36(4): 811–6.

    16. Steffens D, Hancock MJ, Maher CG, et al. Does magnetic resonance imaging predict future low back pain? A systematic review. Eur J Pain, 2014; 18(6): 755–65.

    17. Louw A, Diener I, Fernández-de-las-Peñas C, Puentedura EJ. Sham Surgery in Orthopedics: A Systematic Review of the Literature. Pain Medicine, 2017; 18(4): 736–50.

    18. Mannion AF, Brox JI, Fairbank JC. Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials. Spine J, 2013; 13(11): 1,438–48.

    19. Bagg MK, McAuley JH, Moseley GL, Wand BM. Recent data from radiofrequency denervation trials further emphasise that treating nociception is not the same as treating pain. Br J Sports Med, 2019; 53(13): 841–2.

    20. de Schepper EI, Koes BW, Oei EH, et al. The added prognostic value of MRI findings for recovery in patients with low back pain in primary care: a 1-year follow-up cohort study. Eur Spine J, 2016; 25(4): 1,234–41.

    21. el Barzouhi A, Vleggeert-Lankamp CL, Lycklama à Nijeholt GJ, et al. Magnetic resonance imaging in follow-up assessment of sciatica. New Engl J Med, 2013; 368(11): 999–1,007.

    22. Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disk: a systematic review. Clin Rehab, 2015; 29(2): 184–95.

    23. Cohen M, Quintner J, van Rysewyk S. Reconsidering the International Association for the Study of Pain definition of pain. Pain Rep, 2018; 3(2): e634.

    24. Baliki MN, Apkarian AV. Nociception, Pain, Negative Moods, and Behavior Selection. Neuron, 2015; 87(3): 474–91.

    25. Chen J. History of pain theories. Neurosci Bull, 2011; 27(5): 343–50.

    26. O’Sullivan PB, Caneiro JP, O’Keeffe M, et al. Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain. Phys Ther, 2018; 98(5): 408–23.

    27. Vlaeyen JWS, Crombez G. Behavioral Conceptualization and Treatment of Chronic Pain. Ann Rev Clin Psych, 2020; 16(1): 187–212.

    28. Menendez ME, Ring D. Factors Associated with Greater Pain Intensity. Hand Clinics, 2016; 32(1): 27–31.

    29. Kraljevic S, Banozic A, Maric A, et al. Parents’ pain catastrophizing is related to pain catastrophizing of their adult children. Int J Behav Med, 2012; 19(1): 115–9.

    30. Palermo TM, Valrie CR, Karlson CW. Family and parent influences on pediatric chronic pain: a developmental perspective. Amer Psych, 2014; 69(2): 142–52.

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  • After passing the course, your certificate will be available for download here.