LOMBALGIAS (3)

LOMBALGIAS - recomendações para o diagnóstico e acompanhamento clinico da dor lombar não específica

GUIDELINES FOR ACUTE NONSPECIFIC LOW BACK PAIN

Based on systematic reviews and existing clinical guidelines.

Summary of recommendations for diagnosis of acute non-specific low back pain:

• Case history and brief examination should be carried out (SABER OUVIR)

• If history taking indicates possible serious spinal pathology or nerve root syndrome, carry out more extensive physical examination including neurological screening when appropriate - PROCURAR SINAIS DE ALERTA PARA DESPISTE DOS CASOS SÉRIOS E ASSOCIADOS AS PATOLOGIA GRAVES (ver à frente os sinais de alerta - RED FLAGS)

• Undertake diagnostic triage at the first assessment as basis for management decisions

• Be aware of psychosocial factors, and review them in detail if there is no improvement (ORIGEM MULTIFACTORIAL - VER POST ANTERIORES)

• Diagnostic imaging tests (including X-rays, CT and MRI) are not routinely indicated for non-specific low back pain. Nem sempre há uma relação linear entre sinais e sintomas obtidos a partir da história clinica /exame clinico e as imagens. Os exames imagialógicos devem ser entendidos como complementares ao exame clínico e não sobrepor-se a ele.

• Reassess those patients who are not resolving within a few weeks after the first visit, or those who are following a worsening course

in EUROPEAN GUIDELINES FOR THE MANAGEMENT OF ACUTE NONSPECIFICLOW BACK PAIN IN PRIMARY CARE (http://www.backpaineurope.org/ )
Maurits van Tulder, Annette Becker, Trudy Bekkering, Alan Breen, Maria Teresa Gil del Real, Allen Hutchinson, Bart Koes, Even Laerum, Antti Malmivaara, on behalf of the COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care