Journal ArticleDOI
Chronic low back pain: pharmacological, interventional and surgical strategies.
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TLDR
This Review summarizes general concepts of CLBP and focuses on evidence supporting the classic medical–technical approaches to CLBP; that is, pharmacotherapy, interventional pain management and surgery.Abstract:
Chronic low back pain (CLBP) is a highly prevalent, costly and disabling condition that is associated with high levels of health-care resource utilization. Over the past few decades, there has been a paradigm shift in our understanding of CLBP. Nowadays, this condition is accepted as a biopsychosocial phenomenon in which anatomical injury interplays with psychosocial factors. The considerable progress made in elucidating the aetiology of low back pain and the sharp increase in related health-care costs have not translated into a decreased prevalence of CLBP or the development of therapies with markedly improved efficacy and safety. Classic medical-technical interventions for CLBP always need to be placed in a broader therapeutic framework comprising physical, psychosocial and behavioural strategies, and must address the patient's welfare in a holistic context. A common key finding in the literature on these interventions for CLBP is their disappointing magnitude of pain reduction and gain in functionality. This Review summarizes general concepts of CLBP and focuses on evidence supporting the classic medical-technical approaches to CLBP; that is, pharmacotherapy, interventional pain management and surgery.read more
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The burden of disease in older people and implications for health policy and practice
Martin Prince,Fan Wu,Yanfei Guo,Luis Miguel Francisco Gutierrez Robledo,Martin O'Donnell,Richard Sullivan,Salim Yusuf +6 more
TL;DR: The authors in this article found that 30.23% of the total global burden of disease is attributable to disorders in people aged 60 years and older, and the leading contributors to disease burden in older people are cardiovascular diseases, malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5), and neurological and mental disorders (6·6%).
Journal ArticleDOI
Low back pain in older adults: risk factors, management options and future directions
TL;DR: Common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults are summarized to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions.
Posted Content
Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation
TL;DR: The evidence suggested that SCS was effective in reducing the chronic neuropathic pain of FBSS and CRPS type I and in delaying refractory angina pain onset during exercise at short-term follow-up.
Journal ArticleDOI
Neuropathic low back pain in clinical practice
TL;DR: This paper reviews the available literature on the role of neuropathic mechanisms in chronic LBP and discusses implications for its clinical management, with a particular focus on pharmacological treatments.
Journal ArticleDOI
Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials.
Harsha Shanthanna,Ian Gilron,Manikandan Rajarathinam,Rizq AlAmri,Sriganesh Kamath,Sriganesh Kamath,Lehana Thabane,Lehana Thabane,Philip J. Devereaux,Mohit Bhandari +9 more
TL;DR: Existing evidence on the use of gabapentinoids in CLBP is limited and demonstrates significant risk of adverse effects without any demonstrated benefit, given the lack of efficacy, risks, and costs associated.
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Journal ArticleDOI
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art
TL;DR: In this article, the authors reviewed the existing evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic pain disability.
Journal Article
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
TL;DR: A review of the existing evidence for the mediating role of pain‐related fear, and its immediate and long‐term consequences in the initiation and maintenance of chronic pain disability, and the implications of the recent findings for the prevention and treatment of chronic musculoskeletal pain.
Journal ArticleDOI
Epidemiological features of chronic low-back pain
TL;DR: Because the validity and reliability of some of the existing data are uncertain, caution is needed in an assessment of the information on this type of pain.
Journal ArticleDOI
The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions
TL;DR: A review of the basic neuroscience processes of pain (the bio part of biopsychosocial, as well as the psychosocial factors, is presented) and on the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms.