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Causes and Diagnostic Strategies for Chronic Low Back Pain
Journal of the Korean Medical Association ; : 482-493, 2007.
Artículo en Coreano | WPRIM | ID: wpr-89778
ABSTRACT
Chronic low back pain (CLBP) has become more prominent with globally increasing life expectancy. Its cause is more attributable to degenerative changes than to traumatic lesions. Although the diagnosis of CLBP is recently on higher demand, lack of clinical features and non-informative imaging findings in patients with CLBP are challenging to clinicians to establish the diagnosis. Therefore, understanding of the new concept of pathogenesis, elimination of prejudice, and evidence-based diagnostic steps are required to resolve the question of pain source. Analysis of pain distribution patterns and careful history taking can be utilized as an initial guide to divide CLBP into somatic and radicular pain. Zygapophyseal joint pain and sacroiliac joint pain representing somatic pain can be further investigated using medial branch and sacroiliac joint blocks. However, comparative blocks are essential to decreased false positive rate. Infiltration of a small volume of local anesthetics can increase the specificity of the procedures. Discogenic pain stemming from internal disk derangement can be confirmed by pressure-controlled discography. Automated discography is recommended to provide the constant rate of dye injection with obviating the fluctuation of intradiscal pressure. Evidencebased concept and diagnostic procedures can provide more accurate and efficient methods to establish the diagnosis of CLBP.
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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Prejuicio / Articulación Sacroiliaca / Esperanza de Vida / Sensibilidad y Especificidad / Dolor de la Región Lumbar / Medicina Basada en la Evidencia / Articulación Cigapofisaria / Diagnóstico / Dolor Nociceptivo / Anestésicos Locales Tipo de estudio: Estudio diagnóstico / Estudio de etiología Límite: Humanos Idioma: Coreano Revista: Journal of the Korean Medical Association Año: 2007 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Prejuicio / Articulación Sacroiliaca / Esperanza de Vida / Sensibilidad y Especificidad / Dolor de la Región Lumbar / Medicina Basada en la Evidencia / Articulación Cigapofisaria / Diagnóstico / Dolor Nociceptivo / Anestésicos Locales Tipo de estudio: Estudio diagnóstico / Estudio de etiología Límite: Humanos Idioma: Coreano Revista: Journal of the Korean Medical Association Año: 2007 Tipo del documento: Artículo