非特异性下腰痛的治疗进展

腰背痛一直是困扰人类生活与工作的常见疾患之一,每年由腰背痛所产生的直接或间接经济损失数额巨大。下腰痛(low back pain,LBP)是以腰骶部疼痛为特征的一组疾病,中老年人患病率高达70%,由于急性腰背痛复发及慢性疼痛从而导致丧失工作能力的概率为75%~85%。根据LBP联邦指南,将下腰痛分为坐骨神经痛/根性疼痛综合征、特异性下腰痛和非特异性下腰痛。非特异性下腰痛是指始发于腰部,既没有神经根受累也没有严重潜在疾患的下腰痛,至今缺乏针对非特异性下腰痛的诊疗规范。非特异性下腰痛是骨伤科门诊中的常见病,其病因复杂、表现多样、检查不明确、治疗效果不佳等困扰着临床医生,临床上绝大部分腰痛属于非特异性下腰痛。此病有反复发作的特点,对患者的生活质量造成严重的影响。非特异性下腰痛的治疗方法众多,主要为运动疗法、传统的中医治疗以及物理疗法,目前预防治疗和微创疗法对治疗非特异性下腰痛的研究也有所增加。本文通过查阅相关文献,将近些年来国内外学者对非特异性下腰痛的治疗进展进行系统陈述。 

Progress in the treatment of nonspecific low back pain

Low back pain has always been one of the most common diseases that plague human life and work. The amount of direct or indirect economic loss that results from low back pain is huge each year. Lower back pain is a group of diseases characterized by pain in the lumbosacral region. The prevalence in middle-aged and elderly people is as high as 70%, and the probability of incapacity due to recurrence of acute low back pain and chronic pain is between 75% and 85%. According to the LBP federal guidelines, lower back pain is classified into sciatica/radicular syndrome, specific low back pain, and nonspecific low back pain. Nonspecific low back pain refers to lower back pain with no nerve root involvement or severe underlying disease originating from the waist. There has been a lack of diagnostic and therapeutic criteria for nonspecific low back pain. Nonspecific low back pain is a common disease of orthopedics in the clinic, which troubles doctors with its complex pathogenesis, diverse manifestation, dubious examination and inconspicuous treatment effect. Most of backache in the clinic belongs to NLBP. It badly affects the life quality of patients with its repeated attack. Numerous treatments for NLBP. Mainly for exercise therapy, traditional Chinese medicine treatment and physical therapy, the current prevention and minimally invasive treatment of nonspecific low back pain research has also increased. On the basis of looking up some literatures, this article will make a systematic statement in the lately progresses from scholars of domestic and international.