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[腰痛:我们最大的敌人?基层医疗中关于疼痛的简要建议]

[Low back pain: Our greatest enemy? Brief advice on pain in primary care].

作者信息

Fernández de Paúl María, García Espinosa María Victoria, Prieto Checa Isabel, Moreno Carrero Patricia, Izquierdo Enríquez Gema, Díaz Crespo Elena

机构信息

Medicina Familiar y Comunitaria, Centro de Salud Benita de Ávila, Madrid, España.

Medicina Familiar y Comunitaria, Centro de Salud Los Alpes, Madrid, España.

出版信息

Aten Primaria. 2025 Mar;57(3):103172. doi: 10.1016/j.aprim.2024.103172. Epub 2024 Dec 27.

Abstract

This article rewievs the available evidence on low back pain, one of the most prevalent conditions and the main cause of disability in most countries according to the latest Global Disease Burden 2021 study, which has led entities such as the WHO to recently publish recommendations on low back pain management. The causes and associated risk factors are analyzed, with more than 90% of low back pain cases being nonspecific and closely related to biopsychosocial context, as well as the role of imaging tests, whose findings have not been proven to be the source of low back pain. Finally, the effectiveness of the different treatments is analyzed, with non pharmacological being the first-line of treatment and pharmacological treatment having a very limited role, despite the excessive use we make of it.

摘要

本文回顾了有关腰痛的现有证据。根据最新的《2021年全球疾病负担》研究,腰痛是大多数国家最普遍的疾病之一,也是残疾的主要原因,这导致世界卫生组织等机构最近发布了关于腰痛管理的建议。文章分析了腰痛的成因及相关风险因素,超过90%的腰痛病例是非特异性的,与生物心理社会背景密切相关,还分析了成像检查的作用,其检查结果尚未被证明是腰痛的根源。最后,文章分析了不同治疗方法的有效性,非药物治疗是一线治疗方法,而药物治疗的作用非常有限,尽管我们过度使用了药物治疗。

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