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Short Notes on Back Pain 2018 - Dr Mark Burgin

09/04/18. Dr. Mark Burgin BM BCh (oxon) MRCGP considers the elements that should be included in a primer for clinical negligence cases involving back pain.

The words ‘back pain’ are often associated with ‘benefits’ and ‘chronic’ and ‘disability’; and although most attacks of back pain get better by 3 months (1) it is the highest cause of years lived with disability. (2)

If back pain is associated with physical labour it would not be expected to occur in sedentary occupations and it would be becoming less common in the UK as more people are involved in sedentary work.

Lifestyle issues such as smoking, alcohol, weight and inactivity have been studied to explain the increasing incidence but perhaps because back pain is not a single entity little progress has been made.

Mechanical back pain is a symptom not a diagnosis making causation a challenge; if the back pain could not be prevented, predicted or treated then no loss can be associated.

The sick note

The law on sick (or fit) notes is contained in statute law and DWP guidance and currently the assessment is whether the patient can do any work rather than their own job. (3)

The GP must perform a ‘suitable clinical assessment’ which can be interpreted from GMC GMP guidance at 15a to mean ‘adequately assess’ including symptoms and social factors and examination. (4)

The note itself should be...

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