Back Pain 300 Series: Advanced Diagnosis & Management

Cost: $300 NZD | Payment plan available at checkout
Study Time: 31hrs (approx.)

CPD Certificates provided.


The Back Pain 300 series of courses is a programme of study designed for physiotherapists, medical practitioners and other health care providers who have experience with managing people with persistent low back pain and referred lower limb pain. 

The Back Pain 300 Starter Pack includes Back Pain 300, and 301 courses that provide an overview of sources of causes of low back pain and introduces the concept of discogenic pain.

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Medical Imaging Course

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Access: 6 Months | Cost: $450.00 NZD

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This course provides a grounding in medical diagnostic imaging concepts for the musculoskeletal, cardio-respiratory and neurological systems. Imaging modalities and views for these body systems and common pathologies are detailed.

Includes "Introduction to Medical Imaging" Course FREE!

New advanced practice opportunities are rapidly emerging for Physiotherapists in primary health care, emergency departments, orthopaedic and other medical specialties. This online learning program has been developed to prepare you to take on these evolving practice roles and will provide others with a broader view of the use of medical imaging in clinical practice.

About this course:

This program provides approx. 16 hours of self-paced learning through 9 comprehensive audio-visual modules supported by extensive readings, case studies, videos and additional resource materials.

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Back Pain 201: Advanced Assessment

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Access: 60 days

Cost: $249 NZD

Study time: 10 hours approximately + self directed reading

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This course is designed for physiotherapists who have some experience and knowledge of assessment and treatment of patients with primary symptoms of back and / or referred lower limb pain. Although my course Back Pain 101 is not a pre-requisite, it is recommended for recent graduates or undergraduates. 

Back Pain 201 opens the door for lumbar spine and pelvic diagnostics and treatment selection based on a broad perspective that includes pathoanatomy, neurophysiology and the psychosocial dimensions by teaching you the essentials of a comprehensive clinical history and physical examination. 

By the end of this course you will be able to confidently identify:

  • Mechanical discogenic pain.
  • Radicular syndromes.
  • Spinal stenosis.
  • Sacroiliac joint pain.
  • Hip and buttock pain sources. 

This course builds on Back Pain 101,  providing a structured assessment method that will be further expanded upon in the Back Pain 300 series.

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Back Pain 101: Basic Assessment & Treatment

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Cost: $160.00 NZD

Access: 60 days

Study time: 10 hours approx.

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This course is designed for physiotherapists who have graduated recently or are starting to learn management of back pain patients. Here you will learn practical hands-on assessment and management that goes beyond international guideline principles. The use of lectures and actual patient video, plus easy to use fillable forms for clinical notes, makes you ready to see patients presenting with a primary symptom of back pain. You also get a complimentary 60 day access to Quick Q&A online questionnaire service so you can identify patients with red flags and those with a high risk of experiencing persistent pain. You can then identify which patients you can manage yourself with good quality basic care and identify those patients who need more advanced knowledge/experience or referral for specialist advice or intervention.

Chapter 1: The Clinical History.

Two lessons, Fillable forms for clinical notes, and video case study of the history taking. You will need to use a form to complete as you watch the patient assessment video. This can be an online form from Quick Q&A (preferred and complimentary), a fillable Adobe form (downloaded from the course website), hard copy (Not recommended). You can use these forms when seeing your own patients in your own clinical environment. These forms are independent of practice management systems and may be printed and added to your practice clinical notes system. There is a quiz at the end of the chapter.

Chapter 2. The Physical examination.

Two lessons, video of assessment procedures: observation, a standard orthopaedic neurologic screening examination. Here you will learn to classify patients into meaningful flexion or extension protocol treatment categories: The red flag and StartBacK screening tool are used to narrow clearly identify the subset of patients the treatment protocols are suitable for and those patients for whom you should seek support for your management. Patients needing more advanced skills or specialist advice are identified early so you can refer them for further, more appropriate care and diagnostic workup. There is a Quiz at the end of the Chapter.

Chapter 3. Treatment.

Four lessons. Those patients with mild or moderate pain and with low or medium risk of persistent pain have been identified. Do the simple things well: an extension protocol, a flexion protocol, When to select which protocol. Learn the specifics of what advice to give, what exercises and posture instruction to recommend, what self-treatment works for most of these patients. Learn how to follow up, progress and discharge patients. Learn basic reporting for back pain patients

Learning outcomes:

  1. Knowledge of prevalence and impact of back pain on the individual and society
  2. Able to carry out an evidence based clinical histor
  3. Able to select appropriate questionnaires to identify red flags
  4. Use the StartBacK screening tool to assess psychosocial distress and risk of persistent pain.
  5. Identify cases with possible radicular pain and/or radiculopathy
  6. Able to identify that subgroup of patients suitable for basic level guideline care, and those patients who require more advanced or specialist level care
  7. Able to do a standard physical examination that includes observation, differentiating between normal asymmetry and relevant deformity, neurologic screening for nerve root compression.
  8. Able to select patients suitable for an extension protocol of exercise, posture adaption
  9. Able to select patients suitable for a flexion protocol of exercise, posture adaption
  10. Lean to follow up in a timely and appropriate manner.
  11. Able to discharge patients in a timely and appropriate manner
  12. Able to adequately document baseline, initial and follow up assessment/treatment findings in clinical notes.   

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3 Case Studies of Persistent Lumbar Spine Pain

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This course presents case studies of three patients seen by Mark Laslett. All have over 2 years of persistent lumbosacral pain and all have had precious unsuccessful treatment. Two cases have clinical diagnoses that were available on the basis of the initial clinical assessment finding. The other case has a clinical diagnosis that is unconfirmed but unneeded for management.


  1. Introduction
  2. Ian. 54 year old salesman with 8 years of persistent central low back pain with daily severe immobilising twinges and intolerance to prolonged sitting.
  3. Rosie. 18 year old athlete with 2 years of dominant buttock pain interrupting professional basketball career.
  4. Tom. 32 year old electrician with 8 years of persistent unilateral low back pain causing him to change occupations three times.
  5. Concluding commentary

The three cases have consented to the assessments and follow ups being videoed for educational purposes. In the clinical assessments video was running continuously and has been edited to remove unnecessary dialog. Captions and annotations added to improve detail and clarity.

Learning activities:

  1. The history, the physical examination and follow up consultations are presented as separate video presentations.
  2. Each case has depersonalized case notes in the form of letters, imaging, and reports. Follow ups are more 12 months.
  3. Reading case notes online and in the course manual.

Learning Outcomes:

  1. Demonstrate 3 different patho-anatomic subsets of non-specific low back pain may be identified by clinical assessment and clinical reasoning
  2. Demonstrate the clinical assessment used in the consultations
  3. Demonstrate appropriate use of and referral for confirmation by reference standard diagnostic procedures
  4. Demonstrate that clinical pathoanatomic diagnosis is necessary in persistent pain so that on-going management and appropriate treatment may be determined.

Study time: Three hours of video. 1-2 hours of reading case notes

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Is a Specific Diagnosis Possible for the Painful Lumbar Spine? Webinar


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This is a Prerecorded Webinar and includes a CPD Certificate at completion.

Access to Course: 30 Days

Cost: $30.00

Course includes:

  • Access to the recorded Webinar: 1 Hour
  • Resources: Manual
  • CPD Certificate

Listen to Dr Mark Laslett’s webinar discussing specific painful lumbar spine diagnoses like discogenic, facetogenic & SIJ pain. It is possible, necessary or desirable? Presentation is followed by Q&A session. 

Here are questions to consider:

  • Is a specific diagnosis possible for back pain patients?
  • How do we know what the cause of back pain is?
  • Is a diagnosis necessary to guide management and treatment?
  • When is it necessary?
  • Does providing a diagnosis carry risks to the patient?
  • Is diagnosis based on imaging like MRI?
  • How do we use our assessment to arrive at a diagnosis?
  • What is the difference between a clinical diagnosis and a reference standard diagnosis?

A diagnosis has three parts (AMP) see graphic

  • Anatomical source of nociception
  • The Mediators of the pain experience and disability
  • The Pathology that causes the tissue to initiate nociception

How we know the cause of symptoms? 

  • Clinical Diagnosis: the identification of source, cause and mediators of the pain experience using demographic information, history, physical examination and simple/cheap tests like X-rays or routine blood tests
  • Reference Standard Diagnosis: the best-known method of reaching a specific diagnosis. In addition to clinical diagnosis methods, this usually involves expensive and invasive diagnostic tests, like Hi-Tech Imaging or controlled anaesthetic blocks, plus a specialist interpretation of all the information.

What are the main sources of the painful lumbar spine? There are 5 basic categories

  • The anterior column: discogenic or vertebral body pain
  • The Lumbar facet joints
  • The sacroiliac joint
  • Central and foraminal stenoses
  • The posterior column other than the facet joint (spondylolisthesis & Baastrups disease)

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Pain 101

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This is the first course in a new online series about Pain.

Presented by Dr Tracey Pons, PhD, NZRPS, Physiotherapy Speacialist (Pain).


Access to this course is for 30 Days.

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In this course we will cover:

  • The definition of pain.
  • Nociception and the protective mechanism normal resting state.
  • Nocifensive behaviour.
  • The transition of acute to persistent pain.
  • Two take home applications.
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Diagnostic Accuracy Course


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This course is intended for all clinicians and students undergoing physiotherapy, medicine and other health related training.

It starts with an introduction to diagnostics as a separate science from therapeutics. Diagnostics has its own conceptual framework and statistical measures. Fortunately, these do not require more than simple mathematics, and the use of an electronic spreadsheet.

The origin of data from diagnostic accuracy studies is described and the international standard for reporting of results is introduced. This is the STARD 2015 document. The concepts of reference standard and index tests, the 2X2 contingency table are introduced. A simple electronic spreadsheet is provided, but the calculation of sensitivity, specificity and the predictive values from the 2X2 contingency table is presented graphically and is easily followed.

The clinical value of sensitivity, specificity and the predictive values is covered in detail, and the effect of prevalence on them explained. The positive and negative likelihood ratios are described, and you learn how to interpret these, calculate pre and post-test probabilities then use them correctly in a clinical setting.

Diagnosis is explained as a sequential, integrated process that involves pattern recognition, ruling in and ruling out possible diagnoses. Though the course starts with very simple concepts, by the end of the 5th lesson you will understand how sequential reasoning and use of multiple clinical tests is validated and used in routine clinical settings.

There are some practical assignments on real data and published papers to help cement in the course content and you can do the quizzes to test your understanding.

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The Shoulder Course Series


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This is a series of five modules covering all aspects of shoulder screening, diagnosis and management.

These courses are designed with the clinician in mind with an emphasis on clinical applicability supported by current, evidence-informed and best practice guidelines. Suitable for any new or recent graduate, or experienced clinician returning to the workforce, or simply wanting to upskill in the diagnosis and management of shoulder pain.

You can enrol in the whole Shoulder Course Series, and online modules and lessons are also available individually. The online courses provide a flexible, convenient, interactive learning environment using a range of written and audiovisual content supported by case studies and clinical reasoning exercises. Optional workshops are available.


Course Aim

To produce practitioners who can:

  1. Accurately screen patients presenting with shoulder girdle symptoms for red flags, and other causes of symptoms that may require additional investigation or treatment in the primary contact setting.
  2. Make an accurate diagnosis of common shoulder conditions using combinations of clinical examination and imaging investigations.
  3. Apply evidence-informed, non-surgical management, including specific physiotherapy treatment and rehabilitation for common shoulder conditions and list the criteria for orthopaedic or other medical referral.
  4. Understand common surgical procedures as they relate to post-operative protocols, and apply appropriate post-operative rehabilitation following these procedures.  

Course Content

There are five online modules in this series:

The Shoulder Screening Module

In this course you will learn how to systematically work through a process of excluding other causes of shoulder pain, obtaining appropriate diagnostic imaging, and then classifying shoulder pain into categories that guide management.

  • Red Flags
  • Health Screening
  • Pain and Psychosocial Modifiers
  • Cervical Spine and Neurological Examination
  • Shoulder Imaging
  • Diagnostic Classification of Shoulder Pain

The Stiff Shoulder Module

In this module you will learn how to make an accurate diagnosis of stiff shoulder conditions using clinical examination and diagnostic imaging, and how to apply evidence-based, management for frozen shoulder and glenohumeral osteoarthritis. 

Lessons in this module:

  • Diagnosis of the stiff shoulder
  • Frozen shoulder
  • Glenohumeral osteoarthritis

The Unstable Shoulder Module

In this module you will learn a classification system for traumatic and atraumatic shoulder instability that helps guide management. You will learn to perform an accurate clinical examination, indications for diagnostic imaging, how to apply evidence-based, non-surgical management including physiotherapy rehabilitation for glenohumeral instability, and know who to refer for orthopaedic evaluation. 

Lessons in this module:

  • Classification of shoulder instability
  • Diagnosis of shoulder instability
  • Management of shoulder instability 

The Rotator Cuff Module

This module covers the pathoaetiology, natural history, diagnosis and management of rotator cuff-related conditions. Lessons in this module begin with the diagnosis of subacromial pain and are then divided according to evidence for specific management of rotator cuff related conditions.

Lessons in this module:

  • Diagnosis of subacromial pain
  • Atraumatic, rotator cuff-related pain
  • Traumatic rotator cuff tears
  • Massive/Inoperable rotator cuff tears
  • Calcific tendinopathy

 The Acromioclavicular Joint

This module covers the pathoaetiology, natural history, diagnosis and management of acromioclavicular and sternoclavicular joint conditions.

Lessons in this module:

  • Diagnosis of acromioclavicular joint pain
  • Acromioclavicular joint instability
  • Acromioclavicular joint arthropathy
  • The Sternoclavicular Joint

Learning Content

Each course consists of a series of modules containing learning activities including:

  • Pre-reading articles
  • Audiovisual presentation
  • Quiz
  • Online forums
  • Ongoing access to closed Facebook groups

A manual is provided for each module that includes copies of slide presentations, references and additional learning resources.

Social Learning

Online Forum

Online forums are available to anyone who completes any of the full modules in the Shoulder Course Series. The purpose of the informal online forums is to ask any questions about the online learning material and to discuss patient cases. A link to the forum will be sent to all those eligible closer to the time. See the SMS website for online forum dates.

Facebook Group

Those who complete any of the full modules in this course are invited to join the corresponding Facebook Group upon completion of the course. Membership to this Group is indefinite. This Group contains social learning units where latest research and updates are organised by topics that align with the modules in this course. You can check off the items you complete and use this for CPD purposes.

Continuing Education Certificates

After completion of each Course (or lesson/module if you are enrolled individually), you will receive a Certificate.

Before you begin

It is recommended you follow SMS on Twitter or Facebook, or check the SMS website to receive notifications of new lessons, updates and clinical resources related to the Shoulder Course Series.

For More Information

If you would like more information about the Shoulder Course Series please visit