Discussion Board Assignment: Red Flags and Initial Management in Acute Low Back Pain

Course: Primary Care Nursing (NURS 420)

Assignment Overview

Participants explore key indicators of serious conditions in patients with acute low back pain and outline initial management strategies in a primary care context. The activity builds skills in recognizing urgent symptoms and applying evidence-based approaches to common musculoskeletal complaints.

Learning Objectives

• Identify common red flags associated with low back pain that suggest underlying serious pathology.
• Explain the rationale for conservative management in most cases of acute low back pain.
• Discuss patient education strategies to promote self-care and prevent recurrence.
• Evaluate peer perspectives on clinical decision-making in primary care scenarios.

Instructions

1. Read the assigned readings on low back pain guidelines and review any provided case examples.
2. Post an initial response addressing red flags, such as neurological deficits or systemic signs, and describe appropriate initial steps like history taking, physical exam, and non-pharmacologic interventions.
3. Support your post with at least two references from current guidelines or studies.
4. Respond to at least two classmates’ posts, offering constructive feedback or alternative views based on evidence.
5. Initial post: 300-500 words; responses: 150-200 words each.
6. Submit by the end of Week 5 via the online forum.
7. Use APA style for citations within the post.

Grading Rubric

• Content accuracy and depth (red flags and management): 40%
• Use of evidence and references: 20%
• Clarity, organization, and grammar: 20%
• Engagement with peers (quality of responses): 20%

Healthcare providers often encounter patients with acute low back pain that resolves without intervention. They focus on screening for red flags like bowel or bladder dysfunction to avoid missing cauda equina syndrome. Initial management emphasizes activity continuation and over-the-counter analgesics for symptom relief.

Learning Materials/Resources

Qaseem, A., Wilt, T.J., McLean, R.M., Forciea, M.A., Denberg, T.D., Barry, M.J., Boyd, C., Chow, R.D., Fitterman, N., Harris, R.P. and Humphrey, L.L. (2017) ‘Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians’, Annals of Internal Medicine, 166(7), pp. 514–530. doi:10.7326/M16-2367.

Stochkendahl, M.J., Kjaer, P., Hartvigsen, J., Kongsted, A., Aaboe, J., Andersen, M., Andersen, M.Ø., Fournier, G., Højgaard, B., Jensen, M.B. and Jensen, L.D. (2018) ‘National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy’, European Spine Journal, 27(1), pp. 60–75. doi:10.1007/s00586-017-5099-2.

Almeida, M., Saragiotto, B., Richards, B. and Maher, C.G. (2018) ‘Primary care management of non-specific low back pain: key messages from recent clinical guidelines’, Medical Journal of Australia, 208(6), pp. 272–275. doi:10.5694/mja17.01152.

Traeger, A.C., Qaseem, A. and McAuley, J.H. (2021) ‘Low back pain’, JAMA, 325(3), pp. 286. doi:10.1001/jama.2020.19715.