Daniels J M
Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield 62794-1613, USA.
Am Fam Physician. 1997 Feb 1;55(2):587-96, 601-2.
Lumbosacral back pain is one of the most common reasons for patients with a work-related injury to present to a primary care physician. In most cases, low back pain has a good prognosis, but the condition is often the source of much frustration for clinicians, patients and employers. The family physician should be able to treat the patient's symptoms and address the psychosocial issues that frequently complicate recovery. Three decision points, based on the history and physical examination, allow the physician to determine the severity of illness and implement an appropriate treatment plan. These three points are as follows: Is it likely that systemic disease or bone pathology is the cause of pain? Has neurologic compromise occurred? Are social or psychologic stressors present that may prolong the clinical course?
腰骶部疼痛是工伤患者就诊于初级保健医生的最常见原因之一。在大多数情况下，腰痛预后良好，但这种情况往往给临床医生、患者和雇主带来诸多困扰。家庭医生应能够治疗患者的症状，并解决那些常常使康复过程复杂化的社会心理问题。基于病史和体格检查的三个决策点，可帮助医生确定疾病的严重程度并实施适当的治疗方案。这三个要点如下：疼痛是否可能由全身性疾病或骨骼病变引起？是否发生了神经功能损害？是否存在可能延长临床病程的社会或心理压力源？
