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Qué es el dolor lumbar y por qué debemos prestar atención

Jan Hartvigsen¹, Mark J Hancock², Alice Kongsted¹

¹Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.

Lancet (London, England)

|March 26, 2018

Resumen

El dolor lumbar es la principal causa mundial de discapacidad, que afecta a todas las edades y países. Su carga está aumentando, especialmente en las naciones de bajos ingresos, lo que requiere una investigación urgente y una acción global.

Área de la Ciencia:

Salud pública
Epidemiología
Tratamiento del dolor

Sus antecedentes:

El dolor lumbar (LBP) es un problema de salud universal, prevalente en todos los países de ingresos y grupos de edad.
A nivel mundial, la discapacidad por LBP aumentó un 54% (1990-2015) debido al crecimiento de la población y al envejecimiento, lo que afectó desproporcionadamente a los países de ingresos bajos y medios.
La LBP es la principal causa de discapacidad en todo el mundo, con causas patológicas específicas identificadas en solo una minoría de casos.

Objetivo del estudio:

Para resaltar la creciente carga global de dolor lumbar como una preocupación de salud pública.
Identificar los factores de riesgo y predictores para el dolor lumbar persistente e incapacitante.
Subrayar la necesidad de intensificar la investigación y las iniciativas globales para controlar el dolor lumbar.

Principales métodos:

Este estudio sintetiza los datos mundiales existentes y los hallazgos de la investigación sobre la prevalencia del dolor lumbar, la discapacidad y los factores de riesgo.
El análisis incluye tendencias en los años de vida ajustados por discapacidad (DALY) atribuidos al dolor lumbar.
La revisión incorpora pruebas sobre el papel de la modulación central del dolor y la cognición del dolor en el dolor lumbar crónico.

Principales resultados:

El dolor lumbar es la principal causa de discapacidad a nivel mundial, con aumentos significativos en los años de discapacidad observados.
Los factores de riesgo para reportar dolor lumbar incluyen trabajos físicamente exigentes, comorbilidades, tabaquismo, obesidad y bajo estatus socioeconómico.
El dolor lumbar incapacitante persistente está asociado con una alta intensidad inicial del dolor, angustia psicológica y dolor en múltiples sitios, influenciado por los mecanismos centrales del dolor.

Conclusiones:

El dolor lumbar representa un desafío creciente para la salud pública mundial, especialmente en entornos con recursos limitados.
La gestión eficaz requiere abordar los factores de riesgo, comprender los mecanismos del dolor y considerar los contextos socioeconómicos y culturales.
La investigación urgente e intensificada y las estrategias globales coordinadas son esenciales para mitigar la carga creciente del dolor lumbar.

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