tailieunhanh - EMERGENCY SEDATION AND PAIN MANAGEMENT - PART 5

Đau lưng cấp tính là một vấn đề rất phổ biến mà ảnh hưởng đến 60-80% người lớn trong cuộc đời của mình. Năm mươi phần trăm người lớn trong độ tuổi lao động sẽ có ít nhất một tập phim của đau lưng trong bất cứ năm nào. T | 17 Analgesia for the Emergency Back Pain Patient Donald Jeanmonod SCOPE OF THE PROBLEM CLINICAL ASSESSMENT PAIN CONSIDERATIONS PAIN MANAGEMENT NSAIDs Skeletal Muscle Relaxants Carisprodol Cyclobenzaprine Diazepam Metaxolone Orphenadrine Opiates Steroids Antidepressants Heat Ice Physical therapy Exercise therapy Spinal Manipulation Acupuncture Facet Injections Epidural Injections FOLLOW-UP CONSIDERATIONS SUMMARY BIBLIOGRAPHY SCOPE OF THE PROBLEM Acute low back pain is a very common problem that affects 60-80 of adults during their lifetimes. Fifty percent of working-age adults will have at least one episode of low back pain during any given year. At any one point in time 15-20 of the population will report having low back pain 1 of the population will be temporarily disabled and 1 of the . population will be chronically disabled from back pain. This equates to million adults in the United States reporting back pain during the year 2000. Low back pain usually starts between age 30 and 50 with the median age of onset at 48 years. Men and women are equally affected by this problem and it crosses all social and racial boundaries. Epidemiologic studies have shown similar prevalence worldwide. Low back pain is second only to upper respiratory problems as the most common symptom-related reason for a physician visit. In 2000 44 million prescriptions were written for low back pain including prescriptions for nonsteroidal anti-inflammatory drugs NSAIDs COX-2 inhibitors 10 and muscle relaxants . Low back pain accounts for a huge financial expenditure. Although patients who become disabled owing to low back pain represent less than 5 of those with low back pain problems they account for up to 60 of the societal costs for this disorder. In 1990 the direct medical costs for treating low back pain exceeded 24 billion and total expenditures of 35-56 billion have been estimated when disability costs are included. CLINICAL ASSESSMENT The majority of low back pain is