1. Treatment of patients with low back pain syndrome
- Author
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Bonda, Gabriela, Sotošek Tokmadžić, Vlatka, Tarčuković, Janja, Šustić, Alan, Župan, Željko, and Ledić, Darko
- Subjects
BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Anesteziologija i reanimatologija ,Lumbago ,Mechanical Low Back Pain ,Lower Back Pain ,Lumbalna bol ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Anesthesiology and Reanimatology ,Mehanička križobolja ,Ponavljajuća križobolja ,Low Backache ,Križobolja ,Recurrent Low Back Pain - Abstract
Lumbalni bolni sindrom je javnozdravstveni problem današnjice i najčešći razlog privremene onesposobljenosti za rad. Riječ je o bolesti multifaktorijalne etiologije, a može biti akutnog, subakutnog i kroničnog tijeka. U većini slučajeva se radi o nespecifičnoj križobolji mehaničke prirode. Bolesnici se prezentiraju bolovima u lumbosakralnoj regiji koja se može i ne mora širiti u noge. Osim boli, može se javiti motorička slabost i hiposenzitivnost. Lumbalni bolni sindrom je najčešće samoograničavajućeg tijeka i ne zahtijeva aktivnu terapiju. No, bitno je učinkovito i pravovremeno izdvojiti one bolesnike kojima je uzrok lumbalnog bolnog sindroma ozbiljno stanje, kao i one s rizikom za razvoj kroničnog lumbalnog bolnog sindroma. Također, lumbalni bolni sindrom može biti praćen psihološkim problemima, osobito kod osoba nižeg socioekonomskog statusa. U tim bi slučajevima psihološka potpora trebala biti dio multidisciplinarnog pristupa zbrinjavanja lumbalnog bolnog sindroma. Metode liječenja ovise o simptomatologiji, duljini trajanja simptoma, mogućnostima i željama bolesnika. Najčešće metode liječenja uključuju kratkotrajnu analgetsku terapiju nesteroidnim antireumaticima uz postupnu mobilizaciju. Tijekom akutne faze moguće je i korištenja fizičkih metoda za smanje boli poput spinalne manipulacije ili primjene termoterapije. Druge metode uključuju akupunkturu, fizikalnu terapiju, blokove živaca i kirurške zahvate. Liječenje se planira u etapama i individualizirano. No, potrebno je unaprijediti smjernice kako bi se izbjegle nepotrebne dijagnostičke pretrage i zahvati, a time i smanjio ekonomski teret lumbalnog bolnog sindroma na zdravstveni sustav., Low back pain syndrome (LBS) is a major public health care problem and the most common reason for temporary incapacity for work. The condition has multifactorial etiology with acute, subacute, or chronic nature. In most cases, LBS involves non-specific low back pain, mechanical in nature. Patients present with pain in the lumbosacral region that may or may not spread to the legs. In addition to pain, motor weakness and hyposensitivity may occur. LBS is usually self-limiting and does not require active therapy. However, in minority of cases LBS can be serious and have debilitating consequences. The emphasis is on proper selection of patients who may have a serious underlying condition for LBP, as well as those who are at risk of developing chronic LBP. It is also important to address psychological problems related to LBP, which are more common in people of lower socio-economic status. Treatment methods depend on the symptoms, duration of symptoms, possibilities, and desires of the patient. The most common treatment methods include short-term analgesic therapy with NSAIDs combined with gradual mobilization. Some patients opt for spinal manipulation or thermotherapy. Other methods are acupuncture, physical therapy, nerve blocks, and surgery. Treatment is individualized and planned in stages. The existing guidelines need to be improved to avoid unnecessary diagnostic tests and procedures, and thus reduce the economic burden of LBP on the healthcare system.
- Published
- 2022