Friday, January 11, 2008

Low back pain week: 2 cases

I am glad to report that this week I was presented with not one, but two cases, both having to do with low back pain.

Case #1


A French-speaking middle-aged man has been referred to me by his physician at the clinic. He suffers from chronic low back pain and would like to know which exercises might help.


First I go to Passeportsanté, hoping to find something in French similar to the MedlinePlus interactive tutorials, or at least with illustrated exercises.

Passportsanté > A-Z > D > Dos (mal de). This takes you to the same page as Douleurs lombaires.

Unfortunately there are no illustrations and certainly nothing interactive. I print it out anyway and then try CiSMeF (sites médicaux francophones à destination des patients et de leurs familles) to see what they have there.

CiSMeF > keywords: "exercises dos." I get two results, neither of which include illustrations, or even examples of exercises. Somewhat interesting though, so I print them out too.

Mal de dos: guide pratique
Mal de dos: pour faire le point

At this point I decide it's time to go to MedlinePlus. Since the information is illustrated, and the patient does speak some English, he will still be able to benefit from it.

MedlinePlus > keywords: "back exercises." I print out the list of results so he can access it again at home, and also print out the text summary of the interactive tutorial (which includes illustrations), and the second hit on the list which is a Low back pain exercise guide from the American Academy of Orthopaedic Surgeons.

Case #2


One of the health professionals (HP) at the clinic comes into my room and asks if there is a pamphlet on back exercises. I know which one he is thinking of but we have run out.


Since the patient speaks English and I have already fielded a similar question earlier in the week, I go directly to MyHq where I have bookmarked some useful links under the Pain management section.

I show the HP the aforementioned MedlinePlus interactive tutorial which he thinks is great (it really is), and Low back pain exercise guide from the American Academy of orthopaedic Surgeons, and this time I also include Low back pain: tips on pain relief and prevention from

I ask the HP to fill out an Rx so I can document the consultation and he is happy to do so even though it means returning to the exam room to get the patient's information (name, chart no.). I run into him later in the hall and he tells me he was impressed by how quickly I was able to find the information and that he is going to go back and explore MedlinePlus for himself.


I often find that the French language information I am able to find is rich in theory and somewhat lacking in terms of image/illustration and maintaining an appropriate reading level. Fortunately most of the patients I see at the clinic are able to read enough English to still benefit from those resources. It is interesting to note that CiSMeF links directly from each topic to the corresponding section in MedlinePlus. All roads lead...

It is also interesting to note that this resource that we (librarians/information professionals) take for granted, is still not well known to all health professionals. I think this is true of many of the resources we use on a regular basis. I have noticed that health professionals at the clinic often request information in pamphlet form, even though they are all too aware that their patients are going online for information. The clinic used to have a "pamphlet room" and a pamphlet database, so I suspect that this is partly due to habit rather than ignorance.


Anonymous said...

Hi Francesca,
Interesting post- it is nice to follow some of your typical encounters and how you resolve them-pilgrimtinker

Anonymous said...

Thanks Pilgrimtinker! I always enjoy reading your thoughts too:-)

Anonymous said...

Hi Francesca,
Maybe you could find some other interesting results with this search strategy:
We also have a dedicated tool for translations You can use it in english (low back pain).
I completely share your views about the lack of illustrations in french language resources. Very accurate point.

FF said...

Hi Gaétan,

THnaks so much for your suggestions- they will be very helpful in future! And thanks for reading:-)