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- Title
Management of chronic low back pain.
- Authors
Bogduk, Nikolai
- Abstract
Treatment for chronic low back pain (pain persisting for over 3 months) falls into three broad categories: monotherapies, mulitidisciplinary therapy, and reductionism.Most monotherapies either do not work or have limited efficacy (eg, analgesics, non‐steroidal anti‐inflammatory drugs, muscle relaxants, antidepressants, physiotherapy, manipulative therapy and surgery).Multidisciplinary therapy based on intensive exercises improves physical function and has modest effects on pain.The reductionist approach (pursuit of a pathoanatomical diagnosis with the view to target‐specific treatment) should be implemented when a specific diagnosis is needed.While conventional investigations do not reveal the cause of pain, joint blocks and discography can identify zygapophysial joint pain (in 15%–40%), sacroiliac joint pain (in about 20%) and internal disc disruption (in over 40%).Zygapophysial joint pain can be relieved by radiofrequency neurotomy; techniques are emerging for treating sacroiliac joint pain and internal disc disruption.
- Publication
Medical Journal of Australia, 2004, Vol 180, Issue 2, p79
- ISSN
0025-729X
- Publication type
Article
- DOI
10.5694/j.1326-5377.2004.tb05805.x