TAILIEUCHUNG - Chapter 016. Back and Neck Pain (Part 11)

Psychiatric Disease CLBP may be encountered in patients who seek financial compensation; in malingerers; or in those with concurrent substance abuse, chronic anxiety states, or depression. Many patients with CLBP have a history of psychiatric illness (depression, anxiety, substance abuse) or childhood trauma (physical or sexual abuse) that antedates the onset of back pain. Preoperative psychological assessment has been used to exclude patients with marked psychological impairments that predict a poor surgical outcome. Unidentified The cause of low back pain occasionally remains unclear. Some patients have had multiple operations for disk disease but have persistent pain and disability. . | Chapter 016. Back and Neck Pain Part 11 Psychiatric Disease CLBP may be encountered in patients who seek financial compensation in malingerers or in those with concurrent substance abuse chronic anxiety states or depression. Many patients with CLBP have a history of psychiatric illness depression anxiety substance abuse or childhood trauma physical or sexual abuse that antedates the onset of back pain. Preoperative psychological assessment has been used to exclude patients with marked psychological impairments that predict a poor surgical outcome. Unidentified The cause of low back pain occasionally remains unclear. Some patients have had multiple operations for disk disease but have persistent pain and disability. The original indications for surgery may have been questionable with back pain only no definite neurologic signs or a minor disk bulge noted on CT or MRI. Scoring systems based upon neurologic signs psychological factors physiologic studies and imaging studies have been devised to minimize the likelihood of unsuccessful surgery. newpage Back Pain Treatment Acute Low Back Pain ALBP ALBP is defined as pain of 3 months duration. Full recovery can be expected in 85 of adults with ALBP without leg pain. Most have purely mechanical symptoms . pain that is aggravated by motion and relieved by rest . Observational studies have been used to justify a minimalist approach to this problem. These studies share a number of limitations 1 a true placebo control group is often lacking 2 patients who consult different provider groups generalists orthopedists neurologists are assumed to have similar etiologies for their back pain 3 no information is provided about the details of treatment and 4 no attempt to tabulate structural causes of ALBP is made. The algorithms for the treatment of back pain Fig. 16-6 draw from published clinical practice guidelines CPGs . However since CPGs are based on incomplete evidence guidelines should not substitute for clinical judgment. .

• Y học thường thức
• Back and Neck Pain
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• BMC Musculoskeletal Disorders
• Neck pain
• Low back pain
• Concomitant neck
• Spinal pain
• Musculoskeletal pain
• Serial cross sectional design
• Neck and shoulder pain
• Back pain
• Body composition
• General population
• Primary care
• Psychological factors
• Population based study
• Ural eye
• Thoracic spine pain
• Appropriateness of care
• Spinal mobilization
• Spinal manipulation
• Chronic low back pain
• Chronic neck pain
• Patient preferences
• Treatment response
• Treatment disability
• Fear avoidance beliefs
• Work disability
• Return to work
• Brief intervention
• Proprioceptive training
• Systematic review
• Chiropractic care
• Visit frequency
• Behavioral model of health services use
• Muskuloskeletal manipulations
• Sports club participation
• Health promotion
• Fear–avoidance beliefs
• Psychosocial work factor
• 7 Steps to a Pain
• health education
• health knowledge
• health
• health care
• medical research