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Clinically Organized Relevant Exam (CORE) Back Tool

2016 Page 1 of 4 Clinically Organized Relevant Exam ( core ) Back ToolThis tool will guide the family physician and/or nurse practitioner to recognize common mechanical back pain syndromes and screen for other conditions where management may include investigations, referrals and specific medications. This is a focused examination for clinical decision-making in primary care. NIFTI is a mnemonic for common red flags Red flags indicate the potential presence of an underlying serious pathology Cauda Equina symptoms require urgent surgical evaluation Yellow flags indicate the potential of psychosocial risk factors for developing chronic pain Yellow flags can be picked up on any visit If significant, CBT or 1:1 psychoeducation counselling may be necessary for pain managementYellow FlagsRed Flags A patient s history can help identify: Back or leg dominant pain Intermittent or constant pain Associated aggravating movement Non-mechanical vs.

Passive hip range of motion Prone Femoral nerve stretch (L3-4) Gluteus maximus power (S1) Saddle sensation testing (S2-3-4) Passive back extension (patient uses arms to elevate upper body) NOTE: Bolded green-coloured tests are the suggested minimum requirements of the exam. March 2016 Imaging tests like X- rays, CT scans and MRIs are not helpful

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  Exams, Ranges, Core, Motion, Relevant, Organized, Clinically, Clinically organized relevant exam

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