Rückenschmerzen in der hausärztlichen Sprechstunde – Abwendbar gefährliche Verläufe sind selten

Akuter Kreuzschmerz gehört zu den häufigsten Beratungsursachen in der ambulanten Versorgung. Diese Arbeit soll einige Ergebnisse der SESAM-Studie, wie auch von anderen, in der ambulanten Versorgung bzw. hausärztlichen Sprechstunde durchgeführten Versorgungsstudien wiedergeben. Die Frage, die uns leitet, besteht vor allem darin, wie die tägliche Praxis der hausärztlichen Sprechstunde tatsächlich mit in Lehrbüchern und Leitlinien gegebenen Differenzialdiagnosen und Versorgungsformen übereinstimmt.

Low back pain is a common reason for encounter that affords a long term, multidisciplinary treatment. This paper is a narrative review of the SESAM-study as well the results of other primary care research evidence. Common diagnoses found in these studies of acute low back pain were: dorsalgia, lumbago with sciatica, other vertebral disc disorders, radiculopathy and other disorders of muscle. Serious disease is rare and in most instances associated with sciatica and low bone density. We conclude that current guidelines for general practitioners should focus on frequent causes of low back pain and stress the importance of the primary care physician rather than the role of multidisciplinary teams in managing patients with low back pain in a cost-effective way.

Key words

Low back pain - general practitioner - primary care - differential diagnosis

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