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Natural Evolution of Nonspecific Low-Back Pain

  • Michel Benoist
  • Thibaut Lenoir
Chapter

Abstract

Information on the prognosis of low-back pain (LBP) is provided by a huge number of epidemiologic studies. This chapter summarizes the natural evolution of nonspecific LBP classified as a function of time: acute, subacute, and chronic, and analyzes the complex relation between pain, back functioning, and disability. It will be shown that the course of LBP at short and long term is not as favorable as originally claimed and that compensation and sick-listing have a deleterious effect on work resumption and recovery. In the second part of the chapter, the authors overview the various factors influencing the development of chronicity and discuss the therapeutic strategies. Schematically, the problem is to differentiate between those patients with a dominant central sensitization who should be directed to intensive rehabilitation and patients with persistence of the peripheral nociceptive input emanating from the degenerative spinal unit, for whom surgery could be considered.

Keywords

Central Sensitization Widespread Pain Work Resumption Compensation Expense Work Incapacity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

HRqol

Health related quality of life

LBP

Low-back pain

MRI

Magnetic resonance imaging

NSN

Nociceptive spinal neuron

RDq

Roland disability questionnaire

SF36

Short from 36

VAS

Visual analog scale

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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.University of Paris VII, Hôpital BeaujonClichyFrance

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