欧洲物理治疗师对下背痛的治疗方法。

The approach of physiatrists to low back pain across Europe.

作者信息

Dincer Fitnat, Kesikburun Serdar, Ozdemir Oya, Yaşar Evren, Munoz Susana, Valero Raquel, Juocevidius Alvydas, Quittan Michail, Lukmann Aet, Winkelman Andreas, Vetra Anita, Gerdle Björn, Kiekens Carlotte, Branco Catarina Aguiar, Smith Eimear, Delargy Mark, Ilieva Elena, Boyer François Constant, Grubisic Frane, Damjan Hermina, Krüger Liisamari, Kankaanpää Markku, Dimitrova Erieta Nikolikj, Delic Marina, Lazovic Milica, Tomic Natasa, Roussos Nikolaos, Michail Xanthi, Boldrini Paolo, Negrini Stefano, Takac Peter, Tederko Piotr, Angerova Yvona

机构信息

Department of Physical Medicine and Rehabilitation, School of Medicine, Hacettepe University, Ankara, Turkey.

Department of Physical Medicine and Rehabilitation, Gülhane School of Medicine, University of Health Sciences, Gaziler Physical Therapy and Rehabilitation Research and Training Hospital, Ankara, Turkey.

出版信息

J Back Musculoskelet Rehabil. 2019;32(1):131-139. doi: 10.3233/BMR-171001.

DOI:10.3233/BMR-171001

PMID:30248029

Abstract

BACKGROUND

Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists.

OBJECTIVE

The present study aimed to investigate the approaches of physiatrists to low back pain across Europe. Preferences, tendencies, and priorities in the diagnosis, management, and treatment of LBP, as well as the epidemiological data pertaining to LBP in PRM practice were evaluated in this Europe-wide study.

METHODS

The study was conducted under the control of the European Society of Physical and Rehabilitation Medicine (ESPRM) Musculoskeletal Disorders Research Committee. A total of 576 physiatrists from most European countries participated in the survey.

RESULTS

The results show that physiatrists frequently deal with patients with LBP in their daily practice. Most patients are not referred to other departments and are treated with various conservative methods. Less than one-fifth of patients are primarily referred for surgery. The physiatrists believe that a clear diagnosis to account for cases of low back pain is rarely established. The most common diagnosis is discopathy. History and physical examination remain the most valuable clinical evaluation tools for low back pain according to physiatrists. Less than half the patients require a magnetic resonance imaging. Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for low back pain. Exercise, back care information, and physical therapy are the preferred conservative treatments. More than half of the physiatrists offer interventional treatments to patients with low back pain.

CONCLUSION

The present study is a preliminary report that presents the attitudes of European physiatrists in the management of low back pain. Further researches are warranted to standardize the conservative management of LBP.

摘要

背景

腰痛是肌肉骨骼疼痛最常见的类型，因此它是物理医学与康复医学中最常遇到的病症之一。主要负责腰痛非手术治疗的医生是物理治疗师。

目的

本研究旨在调查欧洲各地物理治疗师治疗腰痛的方法。在这项全欧洲范围的研究中，评估了腰痛诊断、管理和治疗方面的偏好、倾向和优先事项，以及物理医学与康复实践中与腰痛相关的流行病学数据。

方法

该研究在欧洲物理医学与康复学会（ESPRM）肌肉骨骼疾病研究委员会的控制下进行。来自大多数欧洲国家的576名物理治疗师参与了调查。

结果

结果表明，物理治疗师在日常实践中经常治疗腰痛患者。大多数患者不被转诊至其他科室，而是采用各种保守方法进行治疗。不到五分之一的患者主要被转诊进行手术。物理治疗师认为，很少能明确诊断出导致腰痛的病例。最常见的诊断是椎间盘病。物理治疗师认为，病史和体格检查仍然是腰痛最有价值的临床评估工具。不到一半的患者需要进行磁共振成像检查。非甾体类抗炎药是治疗腰痛最常用的药物。运动、背部护理信息和物理治疗是首选的保守治疗方法。超过一半的物理治疗师为腰痛患者提供介入治疗。