成年人的慢性腰部疼痛:评估和管理
Donald Clinton Maharty1, Shaun C Hines2, Regina Bray Brown3
1Cape Fear Valley Health, Fayetteville, North Carolina; Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek, North Carolina.
American family physician
|April 4, 2024
概括
慢性腰部疼痛影响了许多成年人. 最初的管理侧重于非药物疗法,药物作为二线选择. 早期识别风险因素和预防是关键.
科学领域:
- 医学科学 医学科学 医学科学
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 慢性腰部疼痛 (CLBP) 影响大约13%的美国成年人,持续12周或更长时间.
- 有效的管理需要识别严重疾病的红旗和残疾风险的黄色旗.
- 患者病史,体检和评估根性症状是关键的初步步骤.
研究的目的:
- 概述目前诊断和管理慢性腰部疼痛的最佳实践.
- 区分推和不推的治疗方法.
- 强调急性背痛预防策略的重要性.
主要方法:
- 审查当前的临床指导方针和证据,慢性腰部疼痛管理.
- 强调患者评估,包括病史,体检和红/黄色标志的识别.
- 将治疗方法分为一线 (非药物) 和二线 (药物) 方法.
主要成果:
- 非药物治疗 (运动,物理治疗,咨询) 是一线治疗.
- 非类固醇抗炎药物 (NSAIDs) 和杜洛西丁是最初的药理选择.
- 不建议进行常规成像;诸如外围注射等干预措施是有限的.
结论:
- 优先考虑非药物治疗和慢性腰部疼痛的保守管理.
- 避免在床上休息;专注于积极的患者参与和有针对性的干预.
- 预防策略对于缓解从急性到慢性背痛的进展至关重要.
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