Clients with Low Back Pain? Know When to Co-Manage or Refer Out

Clients with Low Back Pain?
Know When to Co-Manage or Refer Out

We all know low back pain can have many causes. Is it simply sore from a new movement or increased weight, or is it something more serious? What if the pain’s source is actually a disc herniation, joint dysfunction, a spinal infection, or even cancer?

That’s where we come in.

At SF Custom Chiropractic, we know that identifying the source of pain and diagnosing is typically beyond the scope of practice for fitness coaches and trainers. For that reason, we would like to drop some education to help you guide your clients in the right direction. 

Our goal is to provide you with simple and practical information about all musculoskeletal conditions that are most commonly seen with clients that walk into the gym or that get injured while working out.  If you can recognize these conditions then you can refer out correctly and co-manage the client to help them reach their health and fitness goals.  

We want to work with you as a team.  

We don’t want to take clients away or tell them to stop working out.  There are always ways to train around an injury and we emphasize the importance of strengthening and stabilize to prevent future exacerbation.

In this short video, you will learn about low back pain, and more specifically, disc herniations and basic questions to ask when a client says that their low back hurts. 

The 3 Most Common Sources of Low Back Pain

  • Disc/Nerve: Does their low back pain travel down the leg below the knee? This can mean possible disc or nerve entrapment and should be referred for evaluation and co-management. You can test to determine if they are flexion or extension intolerant and use SLR to help distinguish the pain source. SLR + <45 disc  +>60 myofascial
  • SI Joint Dysfunction or Facet Syndrome: Low back Pain, numbness above the knee? +March Test or +Kemps test refer for evaluation / co-management responses quickly to chiropractic adjustments.
  • Sprain/Strain: Is the pain worse with motion? Is the pain present in one direction vs. feels like a stretch in the other direction? Differentiate sprain vs strain. Avoid motion that causes pain, don’t over stretch and work on isometric strength. Refer for evaluation / co-management for soft tissue work

The Top 3 Red Flags to Keep in Mind
(Refer out for further evaluation)

  • Worse at night while laying flat
  • Prior infection with pain.
  • No response to OTC, NSAIDS

What’s to come up on the next newsletter: 

Seven basic exercises to do with all low back patients… stay tuned!

In good health,

The Sports Chiropractors of SF Custom Chiropractic
(Dr. J, Dr. Mills, Dr. Jessica, Dr. Li, Dr. Groff, Dr. Remillard and Dr. Pulmano)


SF Custom Chiropractic

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