Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire ST5 5BG, UK.
Best Pract Res Clin Rheumatol. 2013 Oct;27(5):699-708. doi: 10.1016/j.berh.2013.11.001. Epub 2013 Nov 14.
Low back pain is a challenge for clinicians and researchers, due to the large variability in clinical presentation, lack of consensus regarding diagnostic criteria or clinical classification; wide variation in course and prognosis, and limited success in identifying effective treatments. However, increasing research efforts has generated an expanding body of evidence on the epidemiology, prognosis and treatment of back pain. This paper presents four key developments in research and clinical practice, and describes how these can influence the future direction of back pain research: (1) the increasing awareness of the impact of low back pain on population health; (2) new approaches to describing and investigating course and prognosis of back pain; (3) the need to better understand the bio-psycho-social mechanisms or pathways that explain impact and long-term outcomes in order to inform intervention research; and (4) the potential for stratified models of care to improve patient outcomes and efficiency of care for back pain.
腰痛是临床医生和研究人员面临的挑战，这是由于临床表现的巨大变异性、缺乏关于诊断标准或临床分类的共识、病程和预后的广泛差异，以及在确定有效治疗方法方面的成功有限。然而，越来越多的研究努力产生了大量关于腰痛的流行病学、预后和治疗的证据。本文介绍了研究和临床实践中的四个关键进展，并描述了它们如何影响腰痛研究的未来方向：（1）日益认识到腰痛对人群健康的影响；（2）描述和研究腰痛病程和预后的新方法；（3）需要更好地了解解释影响和长期结果的生物心理社会机制或途径，以便为干预研究提供信息；（4）分层护理模式改善腰痛患者结局和提高护理效率的潜力。
