[Prevention of chronic low-back pain. Article from the psychological point of view.].
Treatment of chronic low back pain (CLBP) is not only expensive, but is frequently not totally effective. For these reasons, it is important that the risk factors that correlate with the development of chronic pain be considered at the early stage of acute low-back pain (ALBP) in order to implement early treatment to prevent the condition from becoming chronic. Although most of the studies in this field suffer from methodological problems, it appears that the ALBP patients who carry the highest risk of becoming chronic are those who report previous pain episodes, who describe their pain as extending over a wide area of their body and as deep and central, who display no objective findings, who suffer from anxiety and depression, and who "always feel sick." The risk in these patients is further increased when they have a lower educational level and are physically inactive. The recommended early treatment includes shorter periods of bed rest, time-contingent rather than pain-contingent medication, aerobic exericises, education in body mechanics, and behavioural training. In light of the need to contain costs, a program for the prevention of chronic back pain can only be provided for those ALBP patients with an increased risk of having CLBP. Further research on the prevention on CLBP is needed.
Basler
H D
HD
Institut für Medizinische Psychologie, Philipps-Universität, Bunsenstraße 3, D-3550, Marburg.