Department of Family Medicine, Alpert Medical School of Brown University, 133 Dellwood Road, Cranston, RI, 02920, USA.
Excellus BlueCross BlueShield, 165 Court Street, Rochester, NY, 14647, USA.
Chiropr Man Therap. 2023 Aug 8;31(1):25. doi: 10.1186/s12998-023-00499-9.
Low back pain (LBP) is the number one cause of disability world-wide. It is also the most expensive area in healthcare. Patient-centered innovations are needed. This paper uses medical storytelling to illustrate the common problems that often lead to unnecessary suffering for patients, and costs to society. We present innovative solutions, including narrative interventions.
We use medical storytelling to present a scenario in which hypothetical twin patients with identical LBP episodes enter the healthcare system, with one twin managed in an appropriate manner, and the other inappropriately.
One twin becomes a chronic LBP sufferer, while the other experiences quick resolution, despite identical conditions. Recommendations are made to de-implement inappropriate action and to implement a more productive approach.
Many patients with LBP descend into chronic pain. This is rarely inevitable based on clinical factors. Much of chronic LBP results from how the condition is handled within the healthcare system. Medical narrative may be one innovation to illustrate the problem of current LBP management, recommend solutions and foster changes in clinical behavior.
The starkly different outcomes for each identical twin are illustrated. Recommendations are made for reframing the situation to de-implement the inappropriate and to implement a more appropriate approach.
下腰痛（LBP）是全球导致残疾的首要原因。它也是医疗保健中最昂贵的领域。需要以患者为中心的创新。本文使用医学叙事来阐明经常导致患者不必要痛苦和社会成本的常见问题。我们提出了创新的解决方案，包括叙事干预。
我们使用医学叙事来呈现一个情景，其中假定的双胞胎患者出现相同的 LBP 发作，进入医疗保健系统，一个双胞胎以适当的方式管理，另一个则不适当。
一个双胞胎成为慢性 LBP 患者，而另一个尽管条件相同，但很快就得到了缓解。建议取消不适当的治疗方法，并实施更有效的方法。
许多 LBP 患者会陷入慢性疼痛。基于临床因素，这种情况很少是不可避免的。大多数慢性 LBP 是由于医疗保健系统中对病情的处理方式造成的。医学叙事可能是一种创新，可以说明当前 LBP 管理的问题，提出解决方案并促进临床行为的改变。
说明了每个同卵双胞胎截然不同的结果。建议重新调整情况，取消不适当的治疗方法，并采用更合适的方法。
