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Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality

Despite the fact that unspecific low back pain is of important impact in general health care, this pain condition is often treated insufficiently. Poor efficiency has led to the necessity of guidelines addressing evidence-based strategies for treatment of lower back pain (LBP). We present some state...

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Detalles Bibliográficos
Autores principales: Werber, Andreas, Schiltenwolf, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041045/
https://www.ncbi.nlm.nih.gov/pubmed/27417632
http://dx.doi.org/10.3390/healthcare4030044
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author Werber, Andreas
Schiltenwolf, Marcus
author_facet Werber, Andreas
Schiltenwolf, Marcus
author_sort Werber, Andreas
collection PubMed
description Despite the fact that unspecific low back pain is of important impact in general health care, this pain condition is often treated insufficiently. Poor efficiency has led to the necessity of guidelines addressing evidence-based strategies for treatment of lower back pain (LBP). We present some statements of the German medical care reality. Self-responsible action of the patient should be supported while invasive methods in particular should be avoided due to lacking evidence in outcome efficiency. However, it has to be stated that no effective implementation strategy has been established yet. Especially, studies on the economic impact of different implementation strategies are lacking. A lack of awareness of common available guidelines and an uneven distribution of existing knowledge throughout the population can be stated: persons with higher risk suffering from LBP by higher professional demands and lower educational level are not skilled in advised management of LBP. Both diagnostic imaging and invasive treatment methods increased dramatically leading to increased costs and doctor workload without being associated with improved patient functioning, severity of pain or overall health status due to the absence of a functioning primary care gate keeping system for patient selection. Opioids are prescribed on a grand scale and over a long period. Moreover, opioid prescription is not indicated properly, when predominantly persons with psychological distress like somatoform disorders are treated with opioids.
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spelling pubmed-50410452016-10-05 Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality Werber, Andreas Schiltenwolf, Marcus Healthcare (Basel) Article Despite the fact that unspecific low back pain is of important impact in general health care, this pain condition is often treated insufficiently. Poor efficiency has led to the necessity of guidelines addressing evidence-based strategies for treatment of lower back pain (LBP). We present some statements of the German medical care reality. Self-responsible action of the patient should be supported while invasive methods in particular should be avoided due to lacking evidence in outcome efficiency. However, it has to be stated that no effective implementation strategy has been established yet. Especially, studies on the economic impact of different implementation strategies are lacking. A lack of awareness of common available guidelines and an uneven distribution of existing knowledge throughout the population can be stated: persons with higher risk suffering from LBP by higher professional demands and lower educational level are not skilled in advised management of LBP. Both diagnostic imaging and invasive treatment methods increased dramatically leading to increased costs and doctor workload without being associated with improved patient functioning, severity of pain or overall health status due to the absence of a functioning primary care gate keeping system for patient selection. Opioids are prescribed on a grand scale and over a long period. Moreover, opioid prescription is not indicated properly, when predominantly persons with psychological distress like somatoform disorders are treated with opioids. MDPI 2016-07-15 /pmc/articles/PMC5041045/ /pubmed/27417632 http://dx.doi.org/10.3390/healthcare4030044 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Werber, Andreas
Schiltenwolf, Marcus
Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title_full Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title_fullStr Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title_full_unstemmed Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title_short Treatment of Lower Back Pain—The Gap between Guideline-Based Treatment and Medical Care Reality
title_sort treatment of lower back pain—the gap between guideline-based treatment and medical care reality
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041045/
https://www.ncbi.nlm.nih.gov/pubmed/27417632
http://dx.doi.org/10.3390/healthcare4030044
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