Therapeutic and organizational approaches to the patient’s with acute back pain management in outpatient practice (according experience of Croatia and Slovenia).

Prof. Babinets L.S.

Ternopil National Medical University by I.Ya. Gorbachevsky Ministry of Health of Ukraine

Acute low back pain is one of the most common health problems in family medicine. This pain is experienced at least once in the life of 60-80% of people. The aim is to analyze the European (Croatian and Slovenian) experience of medical and organizational approach to the management of a patient with acute back pain in the practice of a primary care physician. Main part. Treatment of low back pain should be comprehensive and not only pharmacological. An appropriate combination with other treatments is required. The patient should be well aware of the nature of his illness. In more patients, a course of treatment and a short hospital stay (up to two weeks) is prescribed by a family doctor. The main purpose of drug treatment is pain relief. Treatment begins with paracetamol, which effectively relieves low back pain, while side effects are very rare. If the effect is weak, use nonsteroidal anti-inflammatory drugs (not recommended for patients with gastric or duodenal ulcers). A small number of patients with acute low back pain develop chronic back pain, which is established as a diagnosis after clinical symptoms persist for six months. It is important to immediately diagnose patients who may initially develop chronic low back pain, which requires referral for additional diagnostic examination, physical therapy, and assessment for temporary or permanent disability. Conclusion: Acute low back pain is a disease in which more than 50% of patients recover within 14 days. 10% of them have chronic pain. Such patients put a serious burden on the family doctor and the health insurance system. These 10% of patients spend almost 90% of the resources allocated to the treatment of low back pain. Diagnosis of acute low back pain should be thorough, which will appoint an effective and rational scheme of management of such a patient in order to correct the clinical condition, pain relief and prevention of chronic acute back pain.

Key Words: acute low back pain, treatment of low back pain, paracetamol, nonsteroidal anti-inflammatory drugs, physical therapy.

https://dx.doi.org/10.15407/internalmed2021.02.028

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Для цитування:

  1. Бабінець, Л.С. Лікувальні та організаційні підходи до ведення пацієнта з гострим болем у спині в амбулаторній практиці (за досвідом Хорватії та Словенії) // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2021. – № 2. – С. 28-32. doi: 15407/internalmed2021.02.028
  2. Babinets LS. Likuvalni ta orhanizatsiini pidkhody do vedennia patsiienta z hostrym bolem u spyni v ambulatornii praktytsi (za dosvidom Khorvatii ta Slovenii). [Therapeutic and organizational approaches to the patients with acute back pain management in outpatient practice (according experience of Croatia and Slovenia)]. Shidnoevr. z. vnutr. simejnoi med. 2021;2:28-32. Ukrainian. doi:10.15407/internalmed2021.02.028

References:

  1. Babinets LS, Halabitska IM. Chronic inflammatory process and bone tissue changes in patients with osteoarthritis and exocrine pancreatic insufficiency. Lekarsky Obzor. 2020;69 (1): 7-10.
  2. DeFrate L, Kim-Wang S, Englander Z, McNulty A. Osteoarthritis year in review 2018: mechanics. Osteoarthritis and Cartilage. 2019;27(3):392-400. http://dx.doi.org/10.1016/j.joca.2018.12.011
  3. Žorž G. Akutna bolečina v križu (Acute Low Back Pain). U: Švab I, Rotar-Pavlič D. Družinska medicina (Family Medicine). − Ljubljana: Združenje zdravnikov družinske medicine (Association of Family Physicians), 2018;:17-24.
  4. Karateev A, Karateev D, Davydov O. PAIN AND INFLAMMATION. PART 1. PATHOGENETIC ASPECTS. Rheumatology Science and Practice. 2017;54(6):693-704. http://dx.doi.org/10.14412/1995-4484-2016-693-704
  5. Koes B, van Tulder M, Lin C, Macedo L, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal. 2010;19(12):2075-2094. http://dx.doi.org/10.1007/s00586-010-1502-y
  6. Murray C, Barber R, Foreman K. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transi-tion. Lancet. 2015 Nov 28;386(10009):2145-91. doi: 10.1016/ S0140-6736(15)61340-X.
  7. Williams C. Low Back Pain and Best Practice Care. Archives of Internal Medicine. 2010;170(3):271. http://dx.doi.org/10.1001/archinternmed.2009.507
  8. Coole C, Watson P, Drummond A. Work problems due to low back pain: what do GPs do? A questionnaire survey. Family Practice. 2009;27(1):31-37. http://dx.doi.org/10.1093/fampra/cmp074
  9. Chou R. Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care From the American College of Physicians. Annals of Internal Medicine. 2011;154(3):181. http://dx.doi.org/10.7326/0003-4819-154-3-201102010-00008
  10. HZZO (Croatian Health Insurance Fund). Izvješće o bolovanju na teret sredstava Hrvatskog zavoda za zdravstveno osiguranje prema međunarodnoj klasifikaciji bolesti za 2018. godinu (Report on Sick-Leave Paid by Croatian Health Insurance Fund in 2018, According to International Classification of Diseases). Available from: www.hzzo-net.hr
  11. Bach S, Holten K. Guideline update: what’s the best approach to acute low back pain? J Fam Pract. 2019;58:E1.
  12. National Institute for Health and Clinical Excellence. Low back pain. Available from: www.nice.org.uk