* All members of the National Care Guideline development group for nonspecific back pain are listed in eBox 1; Section Family Medicine, Institute for Community Medicine, University Hospital of Greifswald; Klinik Münsterland, DRV Westfalen; Department of Orthopedics, Fachklinik Herzogenaurach; ain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Gööttingen; German Agency for Quality in Medicine (AQuMed/ÄZQ), Berlin.
Dtsch Arztebl Int. 2017 Dec 25;114(51-52):883-890. doi: 10.3238/arztebl.2017.0883.
For many years, low back pain has been both the leading cause of days lost from work and the leading indication for medical rehabilitation. The goal of the German Disease Management Guideline (NDMG) on nonspecific low back pain is to improve the treatment of patients with this condition.
The current update of the NDMG on non-specific low back pain is based on articles retrieved by a systematic search of the literature for systematic reviews. Its recommendations for diagnosis and treatment were developed by a collaborative effort of 29 scientific medical societies and organizations and approved in a formal consensus process.
If the history and physical examination do not arouse any suspicion of a dangerous underlying cause, no further diagnostic evaluation is indicated for the time being. Passive, reactive measures should be taken only in combination with activating measures, or not at all. When drugs are used for symptomatic treatment, patients should be treated with the most suitable drug in the lowest possible dose and for as short a time as possible.
A physician should be in charge of the overall care process. The patient should be kept well informed over the entire course of his or her illness and should be encouraged to adopt a healthful lifestyle, including regular physical exercise.
多年来,下背痛一直是导致工作日缺勤的主要原因,也是医疗康复的主要指征。德国非特异性下背痛疾病管理指南(NDMG)的目标是改善此类患者的治疗效果。
目前,非特异性下背痛 NDMG 的更新是基于对系统评价文献进行系统检索所获得的文章。其诊断和治疗建议由 29 个科学医学协会和组织共同努力制定,并在正式的共识过程中获得批准。
如果病史和体检没有引起任何对潜在危险病因的怀疑,目前不需要进一步的诊断评估。只有在与激活措施相结合时,或根本不采取被动、反应性措施。当使用药物进行对症治疗时,应根据患者的具体情况选择最合适的药物,以最低剂量和最短时间进行治疗。
应由医生负责整个治疗过程。应在整个疾病过程中向患者提供充分的信息,并鼓励其采取健康的生活方式,包括定期进行体育锻炼。