TY - JOUR
T1 - Low back pain
T2 - state of art
AU - Negrini, Stefano
AU - Fusco, Claudia
AU - Atanasio, Salvatore
AU - Romano, Michele
AU - Zaina, Fabio
PY - 2008/10
Y1 - 2008/10
N2 - Diagnosis of low back pain (LBP) is made by exclusion of secondary spinal diseases, identifiable in the first month of pain (acute LBP - ALBP) through the so-called "reds flags", and only if pain persists over 4 weeks (sub-acute LBP - SALBP) using diagnostic exams. LBP classification is actually based on the localization (LBP and sciatica) and duration of pain: ALBP, SALBP, and chronic (CLBP) when it lasts over 6 months. ALBP prognosis is very good because it is auto-resolving in most of the cases; on the contrary, CLBP has a bad prognosis (very low rate of resolution even with treatment). The stage of most interest is SALBP, in which it is possible to identify risk factors ("yellow flags") of chronicity and to avoid the development of a series of vicious cycles that, according to a bio-psycho-social model of illness, can lead the patient to CLBP. In CLBP it's mandatory to make the patient able to manage his problem, so to increase his quality of life and decrease disability and pain. Treatment approach to ALBP consist of reassuring the patient and providing accurate preventive information, recommendations to remain as active as possible, to avoid bed rest. In SALBP and CLBP, a multidisciplinary team rehabilitation approach is the most important one, combining educational, cognitive-behavioural and physical exercise treatments according to the individual needs. Pain killer therapies can be proposed, but bearing in mind their short-term effects.
AB - Diagnosis of low back pain (LBP) is made by exclusion of secondary spinal diseases, identifiable in the first month of pain (acute LBP - ALBP) through the so-called "reds flags", and only if pain persists over 4 weeks (sub-acute LBP - SALBP) using diagnostic exams. LBP classification is actually based on the localization (LBP and sciatica) and duration of pain: ALBP, SALBP, and chronic (CLBP) when it lasts over 6 months. ALBP prognosis is very good because it is auto-resolving in most of the cases; on the contrary, CLBP has a bad prognosis (very low rate of resolution even with treatment). The stage of most interest is SALBP, in which it is possible to identify risk factors ("yellow flags") of chronicity and to avoid the development of a series of vicious cycles that, according to a bio-psycho-social model of illness, can lead the patient to CLBP. In CLBP it's mandatory to make the patient able to manage his problem, so to increase his quality of life and decrease disability and pain. Treatment approach to ALBP consist of reassuring the patient and providing accurate preventive information, recommendations to remain as active as possible, to avoid bed rest. In SALBP and CLBP, a multidisciplinary team rehabilitation approach is the most important one, combining educational, cognitive-behavioural and physical exercise treatments according to the individual needs. Pain killer therapies can be proposed, but bearing in mind their short-term effects.
KW - Chronic pain
KW - Low back pain
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=54349113353&partnerID=8YFLogxK
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U2 - 10.1016/S1754-3207(08)70066-X
DO - 10.1016/S1754-3207(08)70066-X
M3 - Article
AN - SCOPUS:54349113353
VL - 2
SP - 52
EP - 56
JO - European Journal of Pain Supplements
JF - European Journal of Pain Supplements
SN - 1754-3207
IS - 1
ER -