A Continuing Medical Education Program:
Authors: Bruce Mitchell, MD; Paul Verrills, MD; David Vivian, MD

Release date: February 2006
Terminiation Date: February 28, 2007

Statement of Need
Often, primary care physicians are the first individuals to diagnose and treat low back pain. The standard of care for low back pain includes medication, passive therapies, active rehabilitation, rest and immobilization. But when these do not help ease patient pain and injections only prolong pain relief, surgical interventions become the next step in the management of the condition.

There are new innovative therapies that are now available and may benefit select patients; some of these procedures enable patients to return to daily activities much sooner.

The purpose of this CME activity is to inform primary care physicians about current surgical interventions — as well as new, minimally invasive therapies — for treating low back pain. When this knowledge is combined with clinical experience, these physicians will be able to determine which patients are best referred to specialists for surgical intervention.

Learning Objectives:
At the conclusion of this activity, the participant should be able to:

Review the process for diagnosing acute and chronic low back pain
Describe existing options for the treatment of low back pain
Identify new minimally invasive procedures that can minimize trauma and improve patient outcomes

Intended Audience:
Primary care physicians who treat patients with low back pain.

About the Authors:
Bruce Mitchell, MD
Dr. Bruce Mitchell has an extensive Sports Medicine background (a previous AFL club doctor) and is currently National President of Sports Medicine Australia. Dr. Mitchell is a Research Fellow at the University of Melbourne, Centre for Health, Exercise and Sports Medicine (CHESM) and has a special interest in the management of hip, buttock, back and groin pain. He is also a Fellow of the American College of Sports Medicine and has recently completed a Master’s of Pain Medicine.

Paul Verrills, MD
Dr. Paul Verrills is currently on the Research Committee for the International Spinal Intervention Society (ISIS) and is a Fellow of the Australasian Faculty of Musculoskeletal Medicine (AFMM). He has extensively trained, lectured and demonstrated on interventional pain management techniques both in Australia and the United States. Dr. Verrills regularly contributes articles to specialist journals on pain management and has a special interest in discogenic low back pain. Dr. Verrills has completed a Master’s of Pain Medicine.

David Vivian, MD
Dr. David Vivian is the President and a Fellow of the Australian Faculty of Musculoskeletal Medicine (AFMM). He has over 25 years experience in pain assessment and management, and a Master’s of Pain Medicine. Dr. Vivian is one of the most experienced doctors in the technique of radiofrequency neurotomy. Dr. Vivian was one of a select group of practitioners who was engaged in the Australian National Musculoskeletal Medicine Initiative sponsored by the Federal Minister of Health and the co-author of the NHMRC Guidelines on Acute Musculoskeletal Pain released in 2004.