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[Guidelines for back pain].

A Becker1, J-F Chenot, W Niebling

  • 1Abteilung Allgemeinmedizin, Universität Göttingen. abecker1@gwdg.de

Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|December 23, 2004
PubMed
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This guideline offers a structured approach to managing chronic back pain, emphasizing early detection and avoiding unnecessary tests. It aims to return patients to usual activities with effective pain relief and considers psychosocial factors.

Area of Science:

  • Evidence-based medicine
  • General practice and family medicine

Context:

  • Chronic back pain is a significant societal health issue, leading to substantial sick leave and early retirement.
  • The German Society of General Practice and Family Medicine (DEGAM) has developed a new evidence-based guideline for low back pain management.
  • The guideline follows the DEGAM's 10-step concept for guideline development.

Purpose:

  • To provide a framework for early detection of complicated clinical conditions in low back pain patients.
  • To minimize unnecessary diagnostic tests and prevent the chronicity of back pain.
  • To guide healthcare professionals in managing uncomplicated, complicated, and radicular pain effectively.

Summary:

  • The guideline defines pain types through patient history and clinical examination, reserving advanced diagnostics for high-risk individuals.

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  • Initial management focuses on structured advice and patient return to usual activities, incorporating effective pain relief.
  • Psychosocial factors influencing prognosis are to be assessed during the first consultation; manual therapy may aid acute pain.
  • Impact:

    • Persistent pain and prolonged sick leave necessitate transfer to multiprofessional management, including pain treatment, behavioral therapy, and physiotherapy.
    • A randomized controlled trial is underway to evaluate the effectiveness of implementing this guideline.
    • The guideline aims to improve patient outcomes and reduce the societal burden of chronic back pain.