Abstract:
Acute low back pain (LBP) stands as a leading cause of activity limitation and work absenteeism, and its associated healthcare expenditures are expected to become substantial when acute LBP develops into a chronic and even refractory condition. Therefore, early intervention is crucial to prevent progression to chronic pain, for which the management is particularly challenging and the most effective pharmacological therapy is still controversial. Current guideline treatment recommendations vary and are mostly driven by expertise with opinion differing across different interventions. Thus, it is difficult to formulate evidence-based guidance when the relatively few randomized clinical trials have explored the diagnosis and management of LBP while employing different selection criteria, statistical analyses, and outcome measurements. This narrative review aims to provide a critical appraisal of current acute LBP management by discussing the unmet needs and areas of improvement from bench-to-bedside, and proposes multimodal analgesia as the way forward to attain an effective and prolonged pain relief and functional recovery in patients with acute LBP.
摘要:
急性下腰痛(LBP)是活动受限和旷工的主要原因,当急性LBP发展为慢性甚至难治性疾病时,其相关的医疗保健支出预计将变得巨大。因此,早期干预对于防止进展为慢性疼痛至关重要,其中管理特别具有挑战性,最有效的药物治疗仍然存在争议。当前的指南治疗建议各不相同,主要是由专业知识驱动的,不同干预措施的意见不同。因此,当相对较少的随机临床试验采用不同的选择标准探索LBP的诊断和管理时,很难制定循证指导。统计分析,和结果测量。这篇叙述性综述旨在通过讨论从工作台到床边的未满足需求和改进领域,对当前急性LBP管理进行批判性评估。并提出了多模式镇痛作为急性LBP患者获得有效和长期疼痛缓解和功能恢复的方法。