Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
Department of Orthopedic Surgery, Hofstra-Northwell Health System, Great Neck, NY, 11021, USA.
Curr Pain Headache Rep. 2019 Mar 11;23(3):23. doi: 10.1007/s11916-019-0757-1.
PURPOSE OF REVIEW: Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general US adult population is 10-30%, and the lifetime prevalence of US adults is as high as 65-80%. RECENT FINDINGS: Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology. Etiologies of low back pain include myofascial pain, facet joint pain, sacroiliac joint pain, discogenic pain, spinal stenosis, and failed back surgery. In chronic back pain patients, a multidisciplinary, logical approach to treatment is most effective and can include multimodal medical, psychological, physical, and interventional approaches. Low back pain is a difficult condition to effectively treat and continues to affect millions of Americans every year. In the current investigation, we present a comprehensive review of low back pain and discuss associated pathophysiology, diagnosis, and treatment.
目的综述：下腰痛可源自三个不同的部位：轴向腰骶部、神经根性和牵涉痛。在美国，一般成年人每年的下腰痛患病率为 10-30%，而美国成年人的终身患病率高达 65-80%。
最新发现：病史、体格检查和诊断性检查是准确诊断和确定患者病理生理学的重要组成部分。下腰痛的病因包括肌筋膜痛、小关节痛、骶髂关节痛、椎间盘源性痛、椎管狭窄和腰椎术后失败综合征。在慢性腰痛患者中，多学科、合乎逻辑的治疗方法最为有效，可包括多模式的医学、心理、物理和介入方法。下腰痛是一种难以有效治疗的疾病，每年仍困扰着数以百万计的美国人。在本次研究中，我们对下腰痛进行了全面综述，并讨论了相关的病理生理学、诊断和治疗。
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