Brief action planning to facilitate the management of acute low back pain with radiculopathy and yellow flags: a case report.

Abstract

Introduction: Brief action planning (BAP) is a collaborative tool to support patients' self-management goal setting and action planning. BAP facilitates patient self-reflection, and provides opportunity to establish goals of their own priority.

Case presentation: A 55 year-old female with recentonset low back pain with L5 nerve root distribution, described severe pain in the low back and sharp pain and tingle-sensations down to her right foot. Pain worsened with sitting, coughing, and bending. She was diagnosed with lumbar and other intervertebral disc disorder with radiculopathy (ICD 10: M51.1).

Treatment: Initial treatment included reassurance, education, promotion of movement, and manual therapies. Symptoms worsened at the eighth visit (five weeks) where she also demonstrated pain-catastrophizing behaviours and an over-reliance on passive treatment strategies (i.e., psychosocial factors or yellow flags). BAP was introduced into her treatment plan to set achievable goals for her care.

Outcome: Decreased pain and disability were reported after incorporating BAP into care. Reduced pain-catastrophizing and reduced over-dependence on passive strategies were also demonstrated. Clinical gains were sustained at the 10-week follow-up assessment.

Key clinical message: We describe the utilization of brief action planning as a technique for improving adherence to evidence-based clinical practice guideline recommendations in a patient with acute low back pain and radiculopathy, and late-onset psychosocial factors.