A derékfájás diagnosztikájának és kezelésének modern nemzetközi elvei

Translated title of the contribution: The modern international principles of diagnosing and treating low back pain

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The author presents the recommendations of international guidelines in the modern diagnosis and treatment of low back pain. Regarding diagnosis, it is very important to differentiate between "specific" and "aspecific" or "nonspecific" low back pain. The term "specific low back pain" includes all diseases and pathologies with well-defined aetiology and pathological process, including bacterial spondylitis, rheumatic spondy-larthropathies, primary or secondary tu-mours, malignancies, myelon- or cauda equine compression, paresis, metabolic base diseases, pathological or nonpathological fractures are suspected. The presence of so called "red flags" indicate"specific" low back pain. This type of low back pain requires quick and precise diagnosis and specific treatment. All other kinds of low back pain, even those with very painful radiculopathy, and without paresis, cauda- or myelon compression can be considered as aspecific, even if caused by a herniated disc, because there is no absolute indication of discectomy. In case of aspecific low back pain, there is no need of any diagnostic imaging methods, because they would not influence treatment. The main points of treatment are to keep the patient active, quick mobilisation with appropriate analgesia and antiinflammatory treatment following no more than 2-3 days of bed rest, and return to work as soon as possible, with easier work conditions if needed. The longer the patient is on sick leave, the higher the risk he or she will never return to work. If initial active treatment is not is effective enough, the patient's case should be reassessed in 3-6 weeks. If a herniated disc is suspected, the necessary imaging methods should be performed, and the patient should be operated if necessary. With this method, chronic, disabling low back pain can be avoided in many cases. The danger of developing chronic low back pain are indicated by the so called "yellow flags": Dissatisfaction with work, allowance claim, insufficient and even false ideas about the causes and consequences of low back pain, fear, anxiety, depression. These problems can be alleviated by the positive athmosphere of the workplace, appropriate patient education, activity, anxiolytic and antidepressant drugs, activity and regular exercise.

Original languageHungarian
Pages (from-to)329-335
Number of pages7
JournalLege Artis Medicinae
Volume21
Issue number5
Publication statusPublished - May 2011

Fingerprint

Low Back Pain
Intervertebral Disc Displacement
Return to Work
Paresis
Spinal Cord
Therapeutics
Spondylitis
Diskectomy
Bed Rest
Sick Leave
Radiculopathy
Metabolic Diseases
Anti-Anxiety Agents
Pathologic Processes
Patient Education
Diagnostic Imaging
Workplace
Analgesia
Antidepressive Agents
Horses

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A derékfájás diagnosztikájának és kezelésének modern nemzetközi elvei. / Bálint, G.

In: Lege Artis Medicinae, Vol. 21, No. 5, 05.2011, p. 329-335.

Research output: Contribution to journalArticle

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