Abstract
Chronic nonspecific low back pain (CNLBP) is defined as pain or discomfort originating from the waist, which lasts for at least 12 weeks, but no radiculopathy or specific spinal diseases. CNLBP is a complicated medical problem and places a huge burden on healthcare systems. Clinical manifestation of CNLBP includes discogenic LBP, zygapophyseal joint pain, sacroiliac joint pain, and lumbar muscle strain. Further evaluation should be completed to confirm the diagnosis including auxiliary examination, functional assessment, and clinical assessment. The principle of the management is to relieve pain, restore function, and avoid recurrence. Treatment includes conservative treatment, minimally invasive treatment, and rehabilitation. Pharmacologic therapy is the first-line treatment of nonspecific LBP, and it is most widely used in clinical practice. Interventional therapy should be considered only after failure of medication and physical therapy. Multidisciplinary rehabilitation can improve physical function and alleviate short-term and long-term pain. The emphasis should be put on the prevention of NLBP and reducing relevant risk factors.
Highlights
Ke Ma,1 Zhi-Gang Zhuang,2 Lin Wang,3 Xian-Guo Liu,4 Li-Juan Lu,5 Xiao-Qiu Yang,6 Yan Lu,7 Zhi-Jian Fu,8 Tao Song,9 Dong Huang,10 Hui Liu,11 You-Qing Huang,12 Bao-Gan Peng,13 and Yan-Qing Liu 14
Chronic nonspecific low back pain (CNLBP) is defined as pain or discomfort originating from the waist, which lasts for at least 12 weeks, but no radiculopathy or specific spinal diseases
It is defined as pain caused by changes in the internal structure of lumbar discs, despite intervertebral discs of normal morphology. e pathologic feature is the formation of zones of vascularized granulation tissue with extensive innervation in fissures extending from the outer part of the annulus to the nucleus pulposus [6]
Summary
Low back pain (LBP), defined as pain or discomfort in the area between the lower ribs and the gluteal folds, is a common and potentially debilitating condition with or without leg pain. Chronic low back pain (CLBP) refers to low back pain lasting for more than 12 weeks. Chronic nonspecific LBP (CNLBP) is defined as pain and discomfort lasting for at least 12 weeks, but no radiculopathy, specific spinal disease, or nerve root pain. It is time for our experts to convene, discuss, and formulate consensus for the diagnosis and treatment of CNLBP in China. It is necessary to refer to existing evidence on the topic and international consensus for the diagnosis and treatment of LBP. We believe that the consensus will be of great significance for pain management in China and will be of great reference value for other national pain experts in the world
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