Лікувальні та організаційні підходи до ведення пацієнта з гострим болем у спині в амбулаторній практиці (за досвідом Хорватії та Словенії)

Abstract

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