A proposal for the organization of the referral of patients with chronicnon-specific low back pain.

A proposal for the organization of the referral of patients with chronicnon-specific low back pain.
Curr Med Res Opin. 2016 Nov;32(11):1903-1909
Authors: Itz C, Huygen F, Kleef MV
Abstract
BACKGROUND: Low back pain in general and specifically chronic low back pain forms a major burden for the patient and society. Recently studies demonstrated that up to 65% of patients evolve to chronic pain as opposed to the previously accepted 8%. As low back pain patients present first with their general practitioner, the latter should establish a treatment plan, including the appropriate referrals. There are, however, no clear guidelines as to how to refer low back pain patients. The process of trial and error of different specialties and treatment possibilities often results in a long and costly trajectory. A better understanding of the subtypes of chronic low back pain, the risks for chronification and fast adequate referral may result in higher patient satisfaction and cost reduction. Proposed solutions: We propose a classification system based on the clinical and anatomical characteristics of axial low back pain, separated from radicular pain. It is important to recognize the risks for chronification, such as degenerative and/or herniated disk, a smaller cross-sectional area of the multifidus, erector spinae, and psoas muscles and psychological and social factors, to be able to provide appropriate management. Also stratification of the patien...

Source: Current Medical Research and Opinion - October 20, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research