Moreno-Gómez-Toledano Rafael, Méndez-Mesón Irene, Aguado-Henche Soledad, Sebastián-Martín Alba, Grande-Alonso Mónica
Universidad de Alcalá, School of Medicine and Health Sciences, Department of Surgery, Medical and Social Sciences, Area of Human Anatomy and Embryology, Universidad de Alcalá, University Campus - C/ 19 Av de Madrid Km 33 600, 28871, Alcalá de Henares, Madrid, Spain.
Departamento de Traumatología, Unidad de Columna, Hospital Universitario de Torrejón, Madrid, Spain.
Curr Pain Headache Rep. 2025 Jan 25;29(1):34. doi: 10.1007/s11916-024-01342-3.
Low back pain (LBP) is considered an important issue of public health, with annual prevalence estimations almost achieving 60% of the worldwide population. Available treatments have a limited impact on this condition, although they allow to alleviate pain and recover the patient's quality of life. This review aims to go deeper on the understanding of this condition, providing an updated, brief, and concise whole picture of this common musculoskeletal problem.
Scientific literature, current clinical practice and clinical guidelines are summarized, focusing on three key aspects: classification of LBP, diagnosis of symptomatic lumbar hernia, and intervention strategies (conservative, surgical, and pharmacological). Benefits and drawbacks of each approach are tackled. The most appropriate intervention for LBP suffers is hitherto a conservative treatment based on therapeutic exercise, manual therapy and therapeutic education on the neurophysiological mechanisms of pain. Whether patient's condition is severe, does not improve with conservative treatment, or presents neurological symptoms, then surgical intervention is recommended. The efficiency of pharmaceutical approaches for LBP lacks high-quality evidence-based studies, and still needs to be in-depth explored. Current treatments help to improve symptoms and patient's perspectives. However, further research in the field of herniated discs is essential in order to seek a therapy that could definitely cure or eliminate this condition.
腰痛（LBP）被视为一个重要的公共卫生问题，据估计其年患病率几乎达到全球人口的60%。尽管现有治疗方法能缓解疼痛并恢复患者的生活质量，但对这种疾病的影响有限。本综述旨在更深入地了解这种疾病，提供关于这个常见肌肉骨骼问题的最新、简要且精确的全貌。
总结了科学文献、当前临床实践和临床指南，重点关注三个关键方面：腰痛的分类、有症状腰椎疝的诊断以及干预策略（保守治疗、手术治疗和药物治疗）。探讨了每种方法的利弊。目前针对腰痛患者最合适的干预措施是基于治疗性运动、手法治疗以及关于疼痛神经生理机制的治疗性教育的保守治疗。如果患者病情严重，保守治疗无效或出现神经症状，则建议进行手术干预。药物治疗腰痛的有效性缺乏高质量的循证研究，仍需深入探索。目前的治疗有助于改善症状和患者的状况。然而，椎间盘领域的进一步研究对于寻找一种能够确切治愈或消除这种疾病的疗法至关重要。
