[What helps in back pain? Guideline for symptomatic therapy].
Both in acute and chronic, unspecific back pain, the myofascial pain syndrome resulting in muscular dysbalance is a major factor. For the differential diagnosis, however, consideration must always be given to concomitant symptoms (neurological deficits, general symptoms, signs of osteopathy). Pathophysiologically, the active trigger point corresponds to a contraction in the muscle fibers that forms in the region of the a neuromuscular endplate, and leads, via biochemical processes, to the stimulation of mesochymal nociceptors. Symptomatic treatment of acute and chronic back pain may be broken down into a) physical measures, b) local therapeutic regimens, c) systemic pharmacotherapy. As medication, non-steroidal antiinflammatory drugs, non-opioid analgesics, opioid analgesics, muscle relaxants and antidepressives are available, and are dose-matched to the severity and stage of the condition. The spectrum of therapeutic options is outlined.
Pongratz
D
D
Klinikum Innestadt der Ludwig-Maximilians-Universität München.
Späth
M
M
D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000534:rehabilitation*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009465:Neuromuscular Agents