TY - JOUR
T1 - Nonsurgical care of low back pain.
AU - Deyo, R. A.
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 1991/10
Y1 - 1991/10
N2 - Based on accumulating evidence, an important shift in the nonsurgical treatment paradigm for low back pain is underway. This shift is away from prolonged rest and passive therapy toward earlier patient activation and greater use of exercise therapy. The patient's best interest is often served by encouraging an early return to work and by avoiding adversarial legal proceedings. Patients should be reassured about the good prognosis of acute pain, and the alarming terminology of "injury" or "ruptured disc" should be avoided. Intervention to avoid sedentariness, smoking, and obesity probably offers important therapeutic and preventive opportunities. When surgery is indicated, the patient should have a major role in decision making after being provided an accurate view of risks and benefits of surgical intervention. Surgery should generally be reserved for those cases for which a benefit of surgery has been clearly established, avoiding the liberalization of indications to include imaging findings alone, persistent pain alone, or the failure of other treatments in the absence of clear surgical indications.
AB - Based on accumulating evidence, an important shift in the nonsurgical treatment paradigm for low back pain is underway. This shift is away from prolonged rest and passive therapy toward earlier patient activation and greater use of exercise therapy. The patient's best interest is often served by encouraging an early return to work and by avoiding adversarial legal proceedings. Patients should be reassured about the good prognosis of acute pain, and the alarming terminology of "injury" or "ruptured disc" should be avoided. Intervention to avoid sedentariness, smoking, and obesity probably offers important therapeutic and preventive opportunities. When surgery is indicated, the patient should have a major role in decision making after being provided an accurate view of risks and benefits of surgical intervention. Surgery should generally be reserved for those cases for which a benefit of surgery has been clearly established, avoiding the liberalization of indications to include imaging findings alone, persistent pain alone, or the failure of other treatments in the absence of clear surgical indications.
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U2 - 10.1016/s1042-3680(18)30705-8
DO - 10.1016/s1042-3680(18)30705-8
M3 - Review article
C2 - 1840391
AN - SCOPUS:0026234102
SN - 1042-3680
VL - 2
SP - 851
EP - 862
JO - Neurosurgery clinics of North America
JF - Neurosurgery clinics of North America
IS - 4
ER -