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Chiropractic care in office 003
By admin | September 7, 2011
Why Is There a Need to IdentifyPsychosocial Yellow Flags?In New Zealand, just as in the United States, there is asteady increase in the number of people who leave the workforceas a result of protracted or chronic back pain. The riskof permanent disability increases when yellow flags are present chiropractor westlakeand appears to be associated with an increased proportionof patients who do not recover normal function and activitytolerance. An increased research base over the last 5years regarding risk factors resulting in long-term work disabilityis inconsistent or lacking for many chronic painfulconditions, except low back pain. Because most of theknown risk factors are psychosocial, it is recommended toimplement treatment approaches using the biopsychosocialmodel (Burton, 1995; Cherkin, 1996; Frank, 1996).Who Is At Risk?An individual may be considered at risk if he or she has aclinical presentatioindicators of risk, or several less important factors thatmight be cumulative. Yellow flags include factors that havebeen found to extend resolution beyond the duration of acondition’s natural history. A partial list include the following:• A past history of prior episodes (Burton et al, 1995;Cherkin et al, 1996; Frank et al, 1996; Hazard et al,1996)• Severe pain intensity (Cherkin et al, 1996; Frank et Austin Back Painal, 1996; Hazard et al, 1996)• Duration of symptoms (Von Korff et al, 1993; Lintonet al, 1998)• Anxiety (Cherkin et al, 1996; McMahon et al,1997)• Locus of control (eg, ability to control pain) (Burtonet al, 1995)• Depression (Klenerman et al, 1995; Cherkin et al,1996; Linton and Hallden, 1997)For additional discussion of yellow flags, refer to Chapter21. A questionnaire to help identify the presence of yellowflags is provided in Appendix I. chiropractor westlakePROVIDE REASSURANCE AND ADVICEAs recommended by AHCPR, British Medical Guidelines,and others, offering the patient reassurance will help to alleviateunnecessary anxiety, which often accompaniesacute low back pain. However, a fine line exists betweenn that includes one or more very strong
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