Subgrouping patients with low back pain: a treatment-based approach to classification

摘要: Low back pain (LBP) is a common and costly complaint, with the point prevalence ranging from 12% to 33%, 1-year 22% 65%, lifetime 11% 84%.113 Estimates of economic costs in different countries vary greatly but must be considered substantial burden on society.31 In United Kingdom each year, National Health Service physiotherapy hospital directly related LBP are £150.6 million £512 million, respectively.94 Thirteen percent all unemployed people reported that was reason they were not working.36 States, $26 billion per year health care expenses attributable treating LBP. Individuals incur expenditures about 60% higher than those without pain.83 Australia, estimated direct indirect cost 2001 A$9.17 billion.114 Chronic disabling condition particularly individuals community.30 majority presenting acute LBP, cause thought nonspecific possibly caused by variety etiologies.74 Serious underlying conditions rare.72 While risk factors for multidimensional, physical attributes, socioeconomic status, general medical health, psychological environmental contributing.99 Clinical experience often leads providers believe manual, exercise, traction therapies effective patients Unfortunately, evidence effectiveness these remains suboptimal. studies have described benefit broad range pharmacologic interventions when compared natural history or placebo therapies, benefits small effect sizes, only differences outcome observed alternative compared.24,101,111,112 This understanding can lead mistaken impression among clinicians policy makers there no efficient treatment options The objective this review discuss elements current research may partly explain why so summarize update one approach classification.