Neuropathic low back pain in clinical practice
临床实践中的神经性腰痛

摘要

目的 腰痛是最常见的慢性疼痛疾病之一。本文回顾了关于神经病理机制在慢性腰痛中作用的文献，并讨论了其药物治疗进展。方法 在文献数据库中进行了文献检索，已发表的神经性腰痛文献。对所有相关文献进行评估。结果 慢性腰痛包括创伤性和神经性疼痛。然而，神经性疼痛难以管理。许多慢性下腰痛患者的疼痛对现有治疗无效。仅不到一半的患者通过口服药物疗法获得了具有临床缓解。扑热息痛和非甾体抗炎药虽然广泛用于下腰痛，但不太可能改善神经病变成分和使用神经性腰痛的数据抗抑郁药和加巴喷丁/普瑞巴林等药物是有限的。虽然对改进治疗方案的需求尚未得到满足，但最近的数据表明他喷他多对腰痛的神经病变成分有效。8%辣椒素贴剂和 5% 利多卡因药膏是可用作治疗外周疾病的局部镇痛药，可能是治疗神经性腰痛的一种有效方法。结论 慢性腰痛通常具有未被充分认识的神经病变成分，难以管理，需要更详尽地探讨和诊断治疗。

Abstract

Objective Low back pain is one of the most common chronic pain disorders. This article reviews the literature on the role of neuropathological mechanisms in chronic low back pain and discusses advances in its pharmacological treatment.
Methods: A literature search was performed in literature databases for published literature on neuropathic low back pain. All relevant literature was evaluated.
Results: Chronic low back pain included traumatic and neuropathic pain. However, neuropathic pain is difficult to manage. Many people with chronic low back pain have pain that is not responsive to existing treatments. Less than half of patients achieved clinical remission with oral drug therapy. Paracetamol and NSAIDs, although widely used for low back pain, are unlikely to improve neuropathy components and data on the use of neuropathic low back pain antidepressants and drugs such as gabapentin/pregabalin are limited. Although there is an unmet need for improved treatment options, recent data suggest that tapentadol is effective against the neuropathic component of low back pain. The 8% capsaicin patch and 5% lidocaine ointment are topical analgesics that can be used to treat peripheral disease and may be an effective treatment for neuropathic low back pain.
Conclusion  s: Chronic low back pain often has an underrecognized neuropathic component that is difficult to manage and requires more detailed investigation, diagnosis and treatment.