Hellsing A L, Linton S J, Kälvemark M
Department of Occupational Medicine, Orebro Medical Center Hospital, Sweden.
Phys Ther. 1994 Feb;74(2):116-24; discussion 125-8. doi: 10.1093/ptj/74.2.116.
This community-based investigation studied patients with acute back/neck pain and prospectively examined risk factors for chronic pain.
One hundred twenty residents (64 men, 56 women) of a rural community in Sweden who were off work or had been examined by a physician rural community in Sweden who were off work or had been examined by a physician because of acute low back/neck pain during a 1-year period were randomly selected to participate in the study.
All subjects were examined by a physical therapist and completed questionnaires relating to their functional ability during activities of daily living. The subjects were then prospectively followed to examine treatment content and possible factors for predicting the development of chronic pain.
The most common symptom was a dull ache (44%), mostly in the low back (56%). In spite of early care, 16 patients who were randomly selected for further study developed chronic pain during the follow-up year. The patients with chronic pain did not differ from those without chronic pain in age, amount of pain, or handicaps. The risk of developing chronic pain, however, was nearly five times higher for those patients whose pain was provoked by trunk movements in several directions at the first clinical examination. When signs of possible nerve root affection were present, the risk for chronic pain development was nearly eight times higher.
These results suggest that more attention may need to be paid to patients with these risk factors, so that effective preventive measures may be developed.
这项基于社区的调查研究了急性背痛/颈痛患者，并前瞻性地考察了慢性疼痛的风险因素。
从瑞典一个乡村社区中随机选取了120名居民（64名男性，56名女性），他们在1年期间因急性下背痛/颈痛而休假或接受过医生检查，被选来参与本研究。
所有研究对象均接受了物理治疗师的检查，并完成了与日常生活活动中的功能能力相关的问卷调查。随后对这些研究对象进行前瞻性随访，以考察治疗内容以及预测慢性疼痛发展的可能因素。
最常见的症状是隐痛（44%），主要发生在下背部（56%）。尽管进行了早期治疗，但在随机选取进行进一步研究的患者中，有16人在随访的一年中发展成了慢性疼痛。患有慢性疼痛的患者在年龄、疼痛程度或残疾情况方面与未患慢性疼痛的患者并无差异。然而，在首次临床检查时，那些因多个方向的躯干运动诱发疼痛的患者发生慢性疼痛的风险几乎高出五倍。当存在可能的神经根受累迹象时，发生慢性疼痛的风险几乎高出八倍。
这些结果表明，可能需要更多地关注具有这些风险因素的患者，以便制定有效的预防措施。
