Treating Chronic Low Back Pain: A Case Discussion
Patients with chronic low back pain constitute about 5% of all patients with back pain and account for over 75% of the cost of low back pain management.1 The economic impact of chronic low back pain stems from prolonged loss of function, resulting in loss of work productivity, treatment costs, and disability payments. Estimates of these costs range from $12.2 to $90.6 billion annually.2 Most primary care clinicians can expect to see at least one patient with low back pain per week. Treating Chronic Low Back Pain: A Case Discussion is a case-based activity describing current guidelines and providing options and tips for individualizing care of your patients with CLBP to improve their quality of life. Medicinal cannabis will be discussed and helpful tools and resources to support the appropriate care of patients with CLBP provided.
After participating in this activity, learners should be able to:
u Provide appropriate assessment and re-assessment of patients with CLBP
u Access tools and resources to describe various non-pharmacologic and OTC treatment options for patients with CLBP
u Describe the pros and cons of using medicinal cannabis for patients with CLBP
This activity is designed for primary care physicians, physician assistants, nurse practitioners and other primary care team members.
Steps to Earn CME/CE credit
Learners must register to participate in and receive credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board. Read the target audience, learning objectives, and author disclosures. Study the educational content online. Online, choose the best answer to each post-test question. To receive a certificate, you must complete the post-test and activity evaluation. Your certificate will be available to you as a downloadable link. You may print the certificate, but you cannot alter it.
0.50 AAFP Prescribed
This Enduring Material activity, Treating Chronic Low Back Pain: A Case Discussion, has been reviewed and is acceptable for up to 0.50 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins February 14, 2020. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
0.50 AMA PRA Category 1 Credit™
The California Academy of Family Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The California Academy of Family Physicians designates this educational activity for a maximum of 0.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
0.50 AOA Category 2-A
The California Academy of Family Physicians is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. This activity is approved for 0.50 AOA Category 2-A credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
0.50 ANCC Contact Hours
The Nurse Practitioner Healthcare Foundation is accredited as a provider of continuing nursing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. This program provides 0.50 contact hours
0.50 CA Board of Registered Nursing
This course is approved for 0.50 contact hours by the Nurse Practitioner Healthcare Foundation, California Board of Registered Nursing, CEP# 16441. Clinicians should only claim credit commensurate with the extent of their participation in the activity.
0.50 AAPA Category I CME
This activity has been reviewed by the AAPA Review Panel and is compliant with AAPA CME Criteria. This activity is designated for 0.50 AAPA Category 1 CME credits. PAs choosing this credit over AMA PRA 1 Category 1 credit(s)™ must go to AAPA’s Learning Central (cme.aapa.org) to complete the activity and receive your AAPA certificate. PAs should only claim credit commensurate with the extent of their participation.
This activity is supported by an unrestricted grant from Pfizer/Lilly.
There is no charge for this activity.
Unlabeled Use Disclosure
This activity will include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA), and the curriculum clearly indicates this fact.
CAFP policy and California state law requires that each learning activity have elements of cultural and linguistic proficiency included in the content. This activity includes these elements.
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The CAFP has made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the learner is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Approval of credit for this continuing education program does not imply endorsement by CAFP of any product or manufacturer identified.
Any medications or treatment methods suggested in this CME activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.
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© 2020 California Academy of Family Physicians, Nurse Practitioner Healthcare Foundation and American Academy of PAs.. All rights reserved. No part of this activity may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.
1. Patrick N et al. Acute and chronic low back pain. Med Clin North Am. 2014 Jul;98(4):777-89, xii.
2. Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J. 2008;8(1):1–7.
Cheri L. Olson, MD
Interstate Postgraduate Medical Association
La Crescent, MN
Julie Ann Theriault, PA-C, BS, DFAAPA
Lead PA for Sutter Medical Group (SMG)
Wendy L. Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP
Adult/Family Nurse Practitioner
Owner – Wright & Associates Family Healthcare
Bedford, New Hampshire
Cheri L. Olson, MD is Medical Director for the Interstate Postgraduate Medical Association and recently retired as Director of the La Crosse –Mayo Family Medicine Residency Program. Dr. Olson, a family physician, has been extensively involved in quality improvement performance, scholarship and leadership in her state, region and in her institution both in the hospital and clinic settings. She is a frequently invited speaker and especially enjoys presenting group American Board of Family Practice Self-Assessment Modules. She enjoyed overhearing a patient tell another that she is “not like other doctors, she’s really down to earth”, and another patient tell her that she likes that she is not a young doctor! Olson is married to an allergist and has 3 children.
Julie Theriault, PA-C is the lead Physician Assistant for Sutter Medical Group (SMG) in Sacramento, CA. She received her BS in Biology (Concentration in Clinical Laboratory Technology, Minor in Chemistry), her certificate as Primary Care Physician Assistant from the University of California, Davis School of Medicine and completed her PA Graduate Geriatric Medicine Program at Stanford University. Julie is an active leader in the American Academy of Physician Assistants (AAPA), having served as Past President of AAPA and Past President of the California Academy of Physician Assistants (CAPA). She also currently serves on the Sutter Medical Group Benefits Committee and Philanthropic Committee.
Wendy Wright, DNP received her Doctor of Nursing Practice in 2019 from the University of Alabama, Tuscaloosa. She is a 1992 graduate of the Adult Primary Care Nurse Practitioner program at Simmons College in Boston, Massachusetts and completed a family nurse practitioner post-master’s program in 1995. She is an adult and family nurse practitioner and the owner of two, nurse practitioner owned and operated clinics within New Hampshire named: Wright & Associates Family Healthcare. Her family practices have won numerous awards, including Top Providers in New Hampshire 2018, Top 20 Fastest Growing Family Business, and Top 20 Women-Owned Business in New Hampshire. In addition, she is the Owner of Partners in Healthcare Education, a medical education company. She is the Past President of NPACE and the Senior lecturer for Fitzgerald Health Education Associates.
Cheri Olson, MD, declares in the past 12 months neither she nor her spouse/partner have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education program.
Julie Theriault, PA-C, declares in the past 12 months neither she nor her spouse/partner have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education program.
Wendy Wright, DNP, FNP-BC, FAANP declares in the past 12 months neither she nor her spouse/partner have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education program.
Conflict of Interest Statements
The California Academy of Family Physicians (CAFP) Committee on Continuing Professional Development is responsible for management and resolution of conflict for any individual who may have influence on content, who have served as faculty, or who may produce CME/CPD content for the CAFP. Management/Resolution may include learner notification, peer review of content before presentation, requirement of EB-CME, changing topics, or even dismissing a potential planning or faculty member.
It is the policy of the CAFP to ensure independence, balance, objectivity, scientific rigor, and integrity in all their continuing education activities. All individuals with potential to influence the content of this program have submitted Conflict of Interest declarations that have been reviewed according to policy. Learner notification of declarations is below. All individuals with potential conflicts have been contacted by CAFP staff or CCPD members, and issues of conflict have been discussed, managed, and resolved.
Curriculum and Planning Committee Members Doug Martin, MD; Cheri Olson, MD; Benjamin Smith, PA-C; Mary Ales, MBA, CPHP, FACEHP; Jerri L. Davis, CHCP; Christopher Larrison; Marie-Michele Leger, MPH, PA-C; Heidi Ness; Kate Nisbet, MBA; Sheila Robertson, MPH; Shelly Rodrigues, MS, CAE, FACEHP; and Phyllis Zimmer, MN, FNP, FAANP, FAAN declare in the past 12 months neither they nor their spouses/partners have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this continuing education program.
- 0.50 AAFP Prescribed
- 0.50 AMA PRA Category 1 Credit™
- 0.50 ANCC Contact Hours
- 0.50 AOA Category 2-A
- 0.50 CA Board of Registered Nursing