TAILIEUCHUNG - Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 16

Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 16. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Pathways of Spinal Pain Chapter 5 125 that operate in sensory pathways to generate those neural signals that we ultimately interpreted as pain 9 18 55 112 . Epidemiology of Chronic Pain Epidemiological studies show a prevalence of chronic pain from 24 to 46 in the general population 31 102 . Elliott et al. 31 showed that about 15 of patients suffer from the worst degree of pain. The most frequently reported forms of pain in this study are back pain and arthritic pain. In a 1-year follow-up study 79 of patients reporting chronic pain at the baseline investigation still suffered from pain at the end of the study 31 . During this period the average annual incidence was about whereas the recovery rate was about 31 . Chronic pain is localized in 90 of patients to the musculoskeletal system. The incidence of musculoskeletal pain is reported to vary from 21 for shoulder pain up to 85 for low back pain in the industrialized nations 3 10 24 42 . The reported lifetime prevalence of back pain is 84 15 and that of neck pain 67 20 . Dorsal thoracic pain is muchless frequent. The 1-year prevalence of dorsal pain was 17 compared to 64 for neck and 67 for low back pain in a Finnish study 85 . In a primary care setting most patients improve considerably during the first 4 weeks after seeking treatment. Sixty-six to 75 continue to experience at least mild back pain 1 month after seeking care. At 1 month approximately 33 report continuing pain of at least moderate intensity whereas 20-25 report substantial activity limitations. After more than 1 year approximately 33 of patients report intermittent or persistent pain of at least moderate intensity 14 continue to report back pain of severe intensity and 20 report substantial activity limitations 118 . The patient population suffering from chronic back pain has been found to be responsible for an enormous part of the cost of the health care system intake of analgesics medical consultations hospitalizations requirement for .

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