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Low Back Pain: Diagnosis and Management of the Complex Patient

neuroscienceCME Multimedia Snack

Premiere Date: Thursday, November 15, 2012

This activity offers CE credit for:

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Wednesday, November 15, 2017
Note: Credit Is No Longer Available


Steven P. Stanos, DOSteven P. Stanos, DO (Moderator)
Executive Medical Director, Rehabilitation and Performance Medicine
Swedish Pain Services
Swedish Health System
Seattle, WA

Amy L. Mestemaker, MDAmy L. Mestemaker, MD 
Medical Director
HomeReach Hospice/Kobacker House
Clinical Instructor for Pain and Palliative Medicine
The Ohio State University Department of Internal Medicine
Columbus, OH

Glenn I. Swimmer, PhDGlenn I. Swimmer, PhD 
PainCare of Northwest Ohio
StressCare Behavioral Health Inc.
Toledo, OH

Statement of Need

Low back pain (LBP) is a major cause of chronic pain in the United States; many patients present to their clinician with a major complaint of compromised activities of daily living and impacts on quality of life, leading to functional disability due to LBP. A whole-person approach to management by an interdisciplinary team can reduce the burden of chronic pain and return many patients to near full functionality. Clinicians need to be aware of the red flags or aberrant behaviors that could be dangerous for the patient. In addition, once the medical regimen is simplified, appropriate and comprehensive follow-up helps patients with long-term coping skills.

This neuroscienceCME Snack introduces you to Joe, a construction worker who is living with chronic low back pain and presents to his primary care provider saying that he can no longer work. A multidisciplinary faculty panel will take the learners through Joe’s case, from pain assessment to red flags to treatment-planning options in order to ease his pain.

  • Stanos SP, McLean J, Rader L. Physical medicine rehabilitation approach to pain. Med Clin North Am. 2007;91(1):57-95. PMID: 17164105.
  • Chou R, Ballantyne JC, Fanciullo GJ, Fine PG, Miaskowski C. Research gaps on use of opioids for chronic noncancer pain: findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):147-159. PMID: 19187891.

    Activity Goal

    The goal of this activity is to provide clinicians with a comprehensive, whole-patient approach to the treatment and long-term management of chronic low back pain, allowing patients the best possible outcome and a return to near normal function and quality of life.

    Learning Objectives

    At the end of this CE activity, participants should be able to:

    • Assess patients with low back pain for common red flags that warrant further testing.
    • Develop a coordinated rational management plan for patients with chronic low back pain.

    Financial Support

    CME Outfitters, LLC, gratefully acknowledges an educational grant from Endo Pharmaceuticals and Pfizer Inc. in support of this CE activity.

    Target Audience

    Physicians and health care professionals interested in pain management.

    Credit Information

    CME Credit (Physicians):
    CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CME Outfitters, LLC, designates this enduring material for a maximum of .5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    CPE Credit (Pharmacists):
    ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. .5 contact hours (0.05 CEUs)
    Universal Activity Number: 0376-0000-12-023-H01-P
    Type: knowledge-based

    Post-tests, credit request forms, and activity evaluations must be completed online at (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit

    Disclosure Declaration

    It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

    Dr. Stanos has disclosed that he receives grants from Pfizer Inc. He serves as a consultant to, or is on the advisory boards of, Covidien; Eli Lilly and Company; Endo Pharmaceuticals; King Pharmaceuticals, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; and Purdue Pharma L.P. He is on the speakers bureaus of Eli Lilly and Company; Endo Pharmaceuticals; Forest Laboratories, Inc.; King Pharmaceuticals, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; and Pfizer Inc.

    Dr. Mestemaker has no disclosures to report.

    Dr. Swimmer has no disclosures to report.

    Tony Graham, MD (Content/Peer Reviewer) has no disclosures to report.

    Sandra Haas Binford, MAEd (planning committee) has no disclosures to report.

    Joy Barnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

    Unlabeled Use Disclosure

    Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

    CME Outfitters, LLC, the faculty, Endo Pharmaceuticals, and Pfizer Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

    Questions about this activity? Call us at 877.CME.PROS (877.263.7767).


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