[Conservative treatment of chronic low back pain: what is new in 2008?].
An overview of the recent literature on chronic low back pain is presented from a general practitioner's perspective. Several drugs are available however the magnitude of their effect is low and they should be tailored to patient's preference. The cost-benefit ratio of strong opioid is controversial. Different types of exercises have favourable effect on function and quality of life. Graded activity, taking into account kinesio-phobia, may be more important than any specific type of exercise. Spinal infiltration should only be used in much selected patients. In case of unfavourable evolution, multidisciplinary approaches should be the next step. Caring for low back pain patients is a difficult exercise. There is no universal recipe. The emphasis should be put on tailoring treatment approaches to patient perspective.
Balagué
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F
Service de rhumatologie Hôpital fribourgeois-site hôpital cantonal, Fribourg. balaguef@h-fr.ch
Ochoa Amaya
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G
Genevay
S
S
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000534:rehabilitation*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal