CAJ | 학술논문

背景腰痛,又称下背痛,是引起功能障碍的主要原因.目的在众多腰痛的诊断和治疗方法中,提供基于循征医学的腰痛诊断和治疗进展.内容临床医生应该首先把腰痛患者归类为机械性、神经性或继发性腰痛,进而给予相应的检查和治疗.趋向机械性腰痛不应该常规使用影像学检查.腰痛患者的一线药物治疗是对乙酰氨基酚或非类固醇类抗炎药.腰痛的物理治疗、神经阻滞和手术等还存在争议,应该根据循征医学证据选择医师所熟悉的治疗.
배경 요통,우칭하배통,시인기공능장애적주요원인.목적 재음다요통적진단화치료방법중,제공기우순정의학적요통진단화치료진전.내용 림상의생응해수선파요통환자귀류위궤계성、신경성혹계발성요통,진이급여상응적검사화치료.추향 궤계성요통불응해상규사용영상학검사.요통환자적일선약물치료시대을선안기분혹비류고순류항염약.요통적물리치료、신경조체화수술등환존재쟁의,응해근거순정의학증거선택의사소숙실적치료.
Background Low back pain is the major cause of disability.Many options are available for evaluation and management of low back pain.Objective The purpose of this review is to present the available evidence for evaluation and management of low back pain based on evidence based medicine( EBM ).Content Clinicians should conduct a focused history and physical examination classify patients' condition into one of the three broad categories,ie mechanical,neuropathic and secondary back pain,and give corresponding examination and treatment.Trend Clinicians should not routinely obtain imaging or other diagnostic tests in patients with mechanical low back pain.For most patients,first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs.Because literature of the results of physical therapy,nerve blocks and surgery are conflicting,clinicians should choose the treatment based on evidence and their experience.