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Review
. 2025 Mar;57(3):103172.
doi: 10.1016/j.aprim.2024.103172. Epub 2024 Dec 27.

[Low back pain: Our greatest enemy? Brief advice on pain in primary care]

[Article in Spanish]
María Fernández de Paúl  1 , María Victoria García Espinosa  2 , Isabel Prieto Checa  2 , Patricia Moreno Carrero  3 , Gema Izquierdo Enríquez  4 , Elena Díaz Crespo  5
Affiliations
Review

[Low back pain: Our greatest enemy? Brief advice on pain in primary care]

[Article in Spanish]
María Fernández de Paúl et al. Aten Primaria. 2025 Mar.

Abstract
in English, Spanish

This article rewievs the available evidence on low back pain, one of the most prevalent conditions and the main cause of disability in most countries according to the latest Global Disease Burden 2021 study, which has led entities such as the WHO to recently publish recommendations on low back pain management. The causes and associated risk factors are analyzed, with more than 90% of low back pain cases being nonspecific and closely related to biopsychosocial context, as well as the role of imaging tests, whose findings have not been proven to be the source of low back pain. Finally, the effectiveness of the different treatments is analyzed, with non pharmacological being the first-line of treatment and pharmacological treatment having a very limited role, despite the excessive use we make of it.

En este artículo se repasa la evidencia disponible acerca de la lumbalgia, una de las afecciones más prevalentes, y la principal causa de discapacidad en la mayoría de los países, según el último estudio de la carga global de la enfermedad de 2021, lo que ha llevado a entidades como la Organización Mundial de la Salud a publicar recientemente unas recomendaciones para el manejo de la lumbalgia crónica.

Se examinan sus causas y factores de riesgo asociados, siendo más del 90% de las lumbalgias inespecíficas, y estando muy relacionadas con el contexto biopsicosocial, y el papel de las pruebas de imagen, cuyos hallazgos no han podido demostrar ser causantes del dolor lumbar en la mayoría de los casos.

Por último, se revisa la efectividad de los tratamientos, siendo el tratamiento de primera línea el no farmacológico, y teniendo el farmacológico un papel muy limitado pese al uso excesivo que se hace de él.

Keywords: Analgesics; Analgésicos; Atención primaria; Educación para la salud; Health education; Low back pain; Lumbalgia; Manejo del dolor; Pain management; Primary health care.

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References

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