Faculty of Health and Wellbeing, Sheffield Hallam University, Broomhall Road, Sheffield S10 2BP, UK.
Nat Rev Rheumatol. 2010 Apr;6(4):199-209. doi: 10.1038/nrrheum.2010.26.
Chronic low back pain and osteoarthritis are two musculoskeletal problems that are highly prevalent in the general population, are frequently episodic and persistent, and are associated with high costs to society, both direct and indirect. This epidemiological picture provides the background that justifies the use of self-management strategies in managing these problems. For this Review, relevant systematic reviews were included that related to effectiveness; other study designs were included that addressed other aspects of the topic. The accepted definition of self-management includes liaison between health professionals and individuals with these problems, as well as independent health-promotion activities. Independent self-management strategies, such as exercise and self-medication, are practiced by individuals in the general population. Consistent evidence shows that self-management programs for osteoarthritis are effective in addressing pain and function, but effect sizes are small and might be clinically negligible. Educational programs for patients with back pain are effective in an occupational setting and if combined with an exercise program. Exercise is an effective strategy in the management of both chronic low back pain and osteoarthritis, although it is unclear what the optimum exercise is. Exercise, supported by advice and education, should be at the core of self-management strategies for chronic low back pain and osteoarthritis.
慢性下背痛和骨关节炎是两种常见于普通人群的肌肉骨骼疾病，它们经常反复发作且持续存在，并给社会带来直接和间接的高成本。这种流行病学情况为使用自我管理策略来管理这些问题提供了依据。在本次综述中，纳入了与有效性相关的系统评价，以及涉及该主题其他方面的其他研究设计。自我管理的公认定义包括卫生专业人员与患有这些问题的个人之间的联系，以及独立的健康促进活动。独立的自我管理策略，如运动和自我用药，在普通人群中由个人实践。一致的证据表明，骨关节炎的自我管理方案在缓解疼痛和功能方面是有效的，但效果大小较小，可能在临床上可以忽略不计。针对背痛患者的教育计划在职业环境中有效，如果与运动计划相结合则更有效。运动是慢性下背痛和骨关节炎管理的有效策略，尽管尚不清楚最佳运动是什么。运动，辅以建议和教育，应成为慢性下背痛和骨关节炎自我管理策略的核心。
