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Review
. 2023 Apr;12(2):377-398.
doi: 10.1007/s40122-023-00479-0. Epub 2023 Feb 10.

Critical Appraisal of Current Acute LBP Management and the Role of a Multimodal Analgesia: A Narrative Review

Magdi Hanna  1 , Serge Perrot  2 , Giustino Varrassi  3
Affiliations
Review

Critical Appraisal of Current Acute LBP Management and the Role of a Multimodal Analgesia: A Narrative Review

Magdi Hanna et al. Pain Ther. 2023 Apr.

Abstract

Acute low back pain (LBP) stands as a leading cause of activity limitation and work absenteeism, and its associated healthcare expenditures are expected to become substantial when acute LBP develops into a chronic and even refractory condition. Therefore, early intervention is crucial to prevent progression to chronic pain, for which the management is particularly challenging and the most effective pharmacological therapy is still controversial. Current guideline treatment recommendations vary and are mostly driven by expertise with opinion differing across different interventions. Thus, it is difficult to formulate evidence-based guidance when the relatively few randomized clinical trials have explored the diagnosis and management of LBP while employing different selection criteria, statistical analyses, and outcome measurements. This narrative review aims to provide a critical appraisal of current acute LBP management by discussing the unmet needs and areas of improvement from bench-to-bedside, and proposes multimodal analgesia as the way forward to attain an effective and prolonged pain relief and functional recovery in patients with acute LBP.

Keywords: Acute pain; Analgesics; Evidence based; Fixed dose combination; Gaps; Guidelines; Low back pain; Multimodal analgesia.

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Figures

Fig. 1
Fig. 1
Current LBP burden. Graphical elaboration of data in [3, 4, 10, 11, 15, 42, 51]. LBP low back pain, YLDs years lived with disability
See this image and copyright information in PMC

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