Low back pain and radicular pain

Боль в пояснице и корешковая боль
Peter Van Wambeke, Anja Desomer, Luc Ailliet, Anne Berquin, Christophe Demoulin, Bart Depreitere, Johan Dewachter, Mieke Dolphens, Patrice Forget, Virginie Fraselle, Guy Hans, Davy Hoste, Geneviève Mahieu, Jef Michielsen, Henri Nielsens, Thomas Orban, Thierry Parlevliet, Emmanuel Simons, Yannick Tobbackx, Jan Van Zundert, Jacques Vanderstraeten, Patrick Vanschaeybroeck, Joan Vlayen, Pascale Jonckheer
2017-01-01

low back painmultidisciplinary rehabilitationradicular painrisk stratificationspinal decompression
FOREWORD 1 -- ALGORYTHM. 4 -- SUMMARY 5 -- 1. INTRODUCTION 7 -- 1.1. METHODS 7 -- 2. ASSESSMENT OF LOW BACK PAIN AND RADICULAR PAIN 8 -- 2.1. HISTORY TAKING AND CLINICAL EXAMINATION 8 -- 2.2. RISK STRATIFICATION 11 -- 2.3. IMAGING 13 -- 3. NON-INVASIVE MANAGEMENT 14 -- 3.1. SELF-MANAGEMENT 14 -- 3.2. SUPERVISED EXERCISE PROGRAMME 15 -- 3.3. MANUAL TECHNIQUES 15 -- 3.4. PSYCHOLOGICAL INTERVENTIONS 16 -- 3.5. MULTIDISCIPLINARY REHABILITATION PROGRAMME 16 -- 3.6. RETURN TO WORK 17 -- 4. PHARMACOLOGICAL INTERVENTIONS 18 -- 4.1. NSAIDS, OPIOIDS OR PARACETAMOL 18 -- 4.2. ANTIDEPRESSANTS AND ANTICONVULSANTS 20 -- 5. INVASIVE INTERVENTIONS 21 -- 5.1. EPIDURAL INFILTRATIONS FOR (SUB)ACUTE RADICULAR PAIN 21 -- 5.2. RADIOFREQUENCY DENERVATION: FOR SUSPECTED CHRONIC FACET JOINT PAIN 22 -- 5.3. SURGICAL SPINAL DECOMPRESSION FOR PERSISTENT RADICULAR PAIN 23 -- 5.4. ARTHRODESIS: ONLY FOR VERY SPECIFIC CASES OF LOW BACK PAIN 23 -- 6. INTERVENTIONS NOT RECOMMENDED 24 -- 7. INTERVENTIONS WITHOUT A CLEAR RECOMMENDATION 26 -- 8. RESEARCH PROPOSITIONS 27 -- 9. TOPICS NOT STUDIED 28 -- 10. IMPLEMENTATION 28 -- 11. GLOSSARY 29 -- 12. QUESTIONNAIRES 30
1
Assessment emphasizes history-taking, clinical examination, risk stratification, and selective use of imaging.
2
Invasive treatments are reserved for specific indications, including epidural infiltrations, radiofrequency denervation, surgical decompression, and arthrodesis in very specific cases.
3
Pharmacological options discussed include NSAIDs, opioids, paracetamol, antidepressants, and anticonvulsants.
4
Recommended non-invasive care includes self-management, supervised exercise, manual techniques, psychological interventions, multidisciplinary rehabilitation, and return-to-work support.
5
The document provides a clinical algorithm for assessing and managing low back pain and radicular pain.

low back pain and radicular pain

assessment and management, including non-invasive, pharmacological, and invasive interventions

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2017-01-01
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Authors
Peter Van Wambeke
Anja Desomer
Luc Ailliet
Anne Berquin
Christophe Demoulin
Bart Depreitere
Johan Dewachter
Mieke Dolphens
Patrice Forget
Virginie Fraselle
Guy Hans
Davy Hoste
Geneviève Mahieu
Jef Michielsen
Henri Nielsens
Thomas Orban
Thierry Parlevliet
Emmanuel Simons
Yannick Tobbackx
Jan Van Zundert
Jacques Vanderstraeten
Patrick Vanschaeybroeck
Joan Vlayen
Pascale Jonckheer
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