Bel ağrısı

Öz

Bel ağrısı dünyada en sık görülen sakatlık nedenidir. Bel ağrısı adölesan yaşlarda da görülebilmekte ve prevelansı yaşla birlikte artmaktadır. Risk faktörleri arasında en önemlisi meslek ve ağır bedensel aktivitelerle ilgili olanlardır. Bel ağrısı, yatarak tedavi edilen hastalıklar içinde beşinci sırada, cerrahi tedavi gerektiren hastalıklar arasında ise üçüncü sırada yer almaktadır. Tedavide amaç semptomların kontrolü ve kronikleşmesinin engellenmesidir. Bu nedenle akut bel ağrısı ile başvuran hasta ile ilk karşılaşmada yeterli ve objektif bir yaklaşımla hastaya güven verilerek güçlü bir hasta-hekim ilişkisi kurulmalıdır. Pasif tedaviler yerine hastanın katılımının sağlandığı, kendi sorumluluğunu aldığı aktif yöntemler kullanılmalıdır.

Anahtar Kelimeler

• bel ağrısı
• sakatlık
• tedavi

Low back pain

Öz

Low back pain is the most common cause of disability in the world. Low back pain can also occur during adolescence, and its prevalence increases with age. The most important risk factors are those related to occupation and heavy physical activities. Low back pain ranks fifth among diseases requiring inpatient treatment and third among diseases requiring surgical intervention. The aim of treatment is to control symptoms and prevent the condition from becoming chronic. For this reason, at the first encounter with a patient presenting with acute low back pain, a strong patient–physician relationship should be established by reassuring the patient through an adequate and objective approach. Instead of passive treatments, active methods that encourage patient participation and personal responsibility should be used.

Anahtar Kelimeler

• low back pain
• disability
• treatment

Kaynakça

1. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ 2006; 332: 1430-4.
2. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S et al; Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet 2018; 391: 2356-67.
3. Swarm RA, Karanikolas M, Rastogi R, Maw M. Pharmacological options for low back pain. Semin Pain Med 2004; 2: 175-85.
4. Cassidy JD, Wedge JH. The Epidemiology and natural history of low back pain and spinal degeneration. In: Kirkaldy-Willis, William H (ed). Managing Low Back Pain second ed. New York 1992: 9-13.
5. Burton AK, Clarke RD, McClune TD, Tillotson KM. The Natural History of Low Back Pain in Adolescents. Spine 1996; 21: 2323-8.
6. Shiri R, Falah-Hassani K, Heliövaara M, Solovieva S, Amiri S, Lallukka T et al. Risk Factors for Low Back Pain: A Population-Based Longitudinal Study. Arthritis Care Res (Hoboken) 2019; 71: 290-9.
7. Papageorgiou AC, Macfarlane GJ, Thomas E, Croft PR, Jayson MI, Silman AJ. Psychosocial factors in the workplace-do they predict new episodes of low back pain? Evidence from the South Manchester Back Pain Study. Spine (Phila Pa 1976) 1997; 22: 1137-42.
8. Kopec JA, Sayre EC, Esdaile JM. Predictors of back pain in a general population cohort. Spine (Phila Pa 1976) 200; 29: 70-7; discussion 77-8.

9. Christine E. Sheffer C, Jeffrey E. Cassisi. Sex Differences in the Presentation of Chronic Low Back Pain. Psychology of Women Quarterly 2002; Volume 26, Issue 4.
10. Duffy RL. Low back pain: an approach to diagnosis and management. Prim Care 2010; 37: 729-41, vi.
11. Boden SD. Bed rest and normal daily activity were equivalent for acute low-back pain. J Bone Joint Surg Am 2003; 85: 975.
12. Roelofs PD, Deyo RA, Koes BW, Scholten RJ, van Tulder MW. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev 2008; 2008(1): CD000396.
13. Cashin AG, Folly T, Bagg MK, Wewege MA, Jones MD et al. Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis. BMJ 2021; 374: n1446.
14. Chou R, Huffman LH; American Pain Society; American College of Physicians. Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicianslinical practice guideline. Ann Intern Med 2007; 147: 505-14.
15. Seco J, Kovacs FM, Urrutia G. The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review. Spine J 2011; 11: 966-77.
16. Shipton EA. Physical Therapy Approaches in the Treatment of Low Back Pain. Pain Ther 2018; 7: 127-137.
17. Abenhaim L, Rossignol M, Valat JP, Nordin M, Avouac B, Blotman F et al. The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain. Spine (Phila Pa 1976) 2000; 25: 1S-33S