Diamond Shari, Borenstein David
Division of Rheumatology, The George Washington University Medical Center, Washington, DC 20037, USA.
Best Pract Res Clin Rheumatol. 2006 Aug;20(4):707-20. doi: 10.1016/j.berh.2006.04.002.
Low back pain is an extremely common patient complaint. Most cases resolve fairly quickly after the acute episode. However, a small but significant number of patients develop chronic low back pain; a persistent disabling condition. Patients suffer from unremitting pain and often become functionally impaired. Multiple patient characteristics have been identified that place patients at risk for developing chronic low back pain. Currently, it is difficult to find clinical guidelines on how best to manage chronic low back pain, and it remains a substantial treatment challenge for both physicians and patients. The causes, risk factors, prognosis and treatment strategies for chronic low back pain will be discussed in this chapter. The evidence regarding different pharmacological and non-pharmacological treatment modalities will be reviewed and a logical, focused treatment strategy will be outlined.
下腰痛是患者极为常见的主诉。大多数病例在急性发作后能较快缓解。然而，有一小部分但数量可观的患者会发展为慢性下腰痛，这这一种持续致残的病症。患者饱受持续不断的疼痛折磨，且功能常受损。已确定多种患者特征会使患者有患慢性下腰痛的风险。目前，很难找到关于如何最佳管理慢性下腰痛的临床指南，这对医生和患者来说仍是一个重大的治疗挑战。本章将讨论慢性下腰痛的病因、风险因素、预后及治疗策略。将回顾有关不同药物和非药物治疗方式的证据，并概述一种合理、有针对性的治疗策略。
