Avtor/Urednik		Kalso, Eija; Allan, Laurie; Dobrogowski, Jan; Johnson, Martin; Krčevski-Škvarč, Nevenka; Macfarlane, Gary J; Mick, Gerard; Ortolani, Sergio; Perrot, Serge; Perucho, Alfredo
Naslov		Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel
Tip		članek
Vir		Curr Med Res Opin
Vol. in št.		Letnik 21, št. 11
Leto izdaje		2005
Obseg		str. 1819-28
Jezik		eng
Abstrakt		Background: Since chronic low back pain (CLBP) is a complex biopsychosocial problem the ideal treatment is multimodal and multidisciplinary. However, in many countries, primary-care physicians care for many people with CLBP and have a pivotal role in selecting patients for more intensive treatmants when these are available. Guidelines on the general use of strong opioids in chronic non-cancer pain have been published but, until now, no specific guidelines were available on their use in chronic low back pain. Given the prevalence of CLBP, and the complex nature of this muftifactorial condition, it was felt that specific, evidence-based recommendations, with a focus on primary-care treatment, would be helpful. Methods: An expert panel drawn from across Europe including pain specialists, anaesthetists, neurologists, rheumatologists, a general practitioner, an epidemiologist and the chairman of a pain charity was therefore convened. The aim of the group was to develop evidence-based recornmendations that could be usad as a framework for more specific guidelines to reflect local differences in the availability of specialist pain services and in the legal status and availability of strong opioids. Statements were based on published evidence (identified by a literature search) wherever possible, and supported by clinical experience when suitable evidence was lacking. Recommendations: Strong opioids have a role in the treatment of low back pain when other treatments have failed. They should be prescribed as pat of a multimodal, and ideally interdisciplinary, treatmant plan. The aim of treatment should be to relieve pain and facilitate rehabilitation.
Deskriptorji		LOW BACK PAIN ANALGESICS, OPIOID PRACTICE GUIDELINES EUROPE