Research: WEILAND and WESSEL,

Listed in Issue 107


WEILAND and WESSEL, Neurologische Klinik des Staedtischen Klinikums, Braunschweig, Germany,, have reviewed (122 references) the evidence for back pain therapy. Abstract: Back pain needs to be classified according to duration, localization, and presence or absence of neurological deficits. The time interval between onset of symptoms and start of treatment should be as short as possible in order to avoid the development of chronicity. Patients should not be immobilized; a better outcome has been shown if patients continue their usual daily activities. First-line medication consists of non-steroidal anti-inflammatory drugs (NSAIDs), to be supplemented at need with opioids and muscle relaxants. Surgical procedures are only indicated in a small number of cases. The same is true for local injections of anaesthetic drugs. A sufficient database showing the efficacy of acupuncture, osteopathy, and chiropractic is lacking to date. In chronic back pain, a multidisciplinary treatment programme needs to be offered comprising physical exercises and behavioural therapy. Antidepressant drugs may also be indicated in chronic back pain.






Weiland T, Wessel K. Therapy of back pain: what is evidence-based? Fortschritte der Neurologie-Psychiatrie 72 (6): 233-250, Jun 2004.


Yes, what back pain patients need to be offered is a multidisciplinary treatment programme. This can't arrive quickly enough in my opinion.

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