PDF(Pubmed)
Abstract：
Low back pain (LBP) is a prevalent condition associated with disability. Treating patients with LBP becomes further complicated by the potential presence of underlying conditions, such as cancer or traumatic injury, or biopsychosocial aspects. LBP usually has a neuropathic component that must be assessed and treated appropriately. Pharmacological management of LBP requires a thorough knowledge of the available agents and the mechanisms of the LBP. Although there are effective pharmacological treatments for LBP, it is important to consider safety issues. Fixed-dose combination products may be helpful, as they can reduce opioid consumption without sacrificing analgesic benefits. Neuromodulation is an important and sometimes overlooked treatment option for LBP and may be appropriate for chronic LBP requiring long-term treatment. Imaging studies support neuroplastic changes in the brain as a result of neuromodulation. Interventional approaches to chronic LBP are numerous and must be appropriately selected based on the individual patient. Evidence in support of epidural injections for LBP is strong for short-term pain control but moderate to limited for long-term relief. Rehabilitation for LBP can be an important element of long-term care, and new forms of rehabilitation programs are being developed using telemedicine. A variety of new and established treatments are available for patients with LBP, and clinicians and patients may benefit from emerging new treatment modalities.
摘要：
下腰痛(LBP)是与残疾相关的普遍病症。由于潜在的潜在疾病的存在，LBP患者的治疗变得更加复杂，比如癌症或外伤，或生物心理社会方面。LBP通常具有必须适当评估和治疗的神经性成分。LBP的药理学管理需要对可用的药物和LBP的机制有透彻的了解。虽然有有效的药物治疗LBP，重要的是要考虑安全问题。固定剂量组合产品可能会有所帮助，因为它们可以在不牺牲镇痛益处的情况下减少阿片类药物的消耗。神经调节是LBP的重要且有时被忽视的治疗选择，可能适用于需要长期治疗的慢性LBP。影像学研究支持神经调节导致的大脑中的神经可塑性变化。慢性LBP的介入治疗方法很多，必须根据患者个体进行适当选择。支持硬膜外注射LBP的证据对于短期疼痛控制是强有力的，但对于长期缓解是中等至有限的。LBP的康复可能是长期护理的重要组成部分，并且正在使用远程医疗开发新形式的康复计划。各种新的和既定的治疗方法可用于LBP患者，临床医生和患者可能受益于新兴的新治疗方式。
