management of acute muscoskeletal pain, Materiały w jezyku angielskim
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cute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute
te Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute
Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Ac
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa
Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal
Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back
Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Lo
Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute
Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior
Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain v Anterior Knee Pain Ant
Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior
MANAGEMENT OF
ACUTE MUSCULOSKELETAL
PAIN
Australian Acute Musculoskeletal Pain Guidelines Group
EVIDENCE-BASED
APPROVED 5 JUNE 2003
BY THE NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL
EVIDENCE-BASED
MANAGEMENT OF
ACUTE MUSCULOSKELETAL
PAIN
Australian Acute Musculoskeletal Pain Guidelines Group
iii
AUSTRALIAN ACADEMIC PRESS
PTY LTD
Brisbane
PARTICIPATION
The work is a joint initiative of the University of Queensland and the Commonwealth Department
of Health and Ageing. The evidence review was undertaken by a multi-disciplinary group.
The following organisations participated in the review and have approved the contents:
•Australian and New Zealand College of Anaesthetists, Faculty of Pain Medicine
•Australian Osteopathic Association
•Australian Rheumatology Association
•Australian Physiotherapy Association
• Chiropractic and Osteopathic College of Australasia
• Chiropractors’ Association of Australia
• Consumers’ Health Forum of Australia
•Royal Australian College of General Practitioners
DISCLAIMER
Every attempt has been made to locate the most recent scientific evidence. Judgment is necessary when
applying evidence in a clinical setting. It is important to note that weak evidence does not necessarily
mean that a practice is unadvisable, but may reflect the insufficiency of evidence or the limitations of
scientific investigation.
This document is intended as a guide to practice. The ultimate decision of how to proceed rests with
the clinician and the patient and depends on individual circumstances and beliefs (NHMRC 1999).
First published in December 2003 by
Australian Academic Press Pty. Ltd.
32 Jeays Street
Bowen Hills QLD 4006
Australia
www.australianacademicpress.com.au
All responsibility for editorial matter rests with Australian Acute Musculoskeletal Pain Guidelines Group.
Any views or opinions expressed are therefore not necessarily those of Australian Academic Press.
Copyright © 2003 Australian Acute Musculoskeletal Pain Guidelines Group
National Library of Australia Cataloguing-in-Publication data:
Evidence-based management of acute musculoskeletal pain.
Bibliography.
For medical professionals.
ISBN 1 875378 49 9.
1. Musculoskeletal system — Diseases — Treatment.
2. Evidence-based medicine. 3. Pain — Treatment. I.
Australian Acute Musculoskeletal Pain Guidelines Group.
616.7
Cover and text design by Andrea Rinarelli of Australian Academic Press, Brisbane.
Typeset in Adobe Garamond by Australian Academic Press, Brisbane.
iv
Contents
List of Tables
..........................................................................................................................................................................................................
List of Figures
...................................................................................................................................................................................................
About the Group:
Australian Acute Musculoskeletal Pain Guidelines Group
...............................
Chapter
1
Executive Summary
.....................................................................................................................................................................................
Rationale
............................................................................................................................................................................................................
Scope
......................................................................................................................................................................................................................
Summary of Findings
.....................................................................................................................................................................
Limitations of Findings
................................................................................................................................................................
>References
...............................................................................................................................................................................................................
Chapter
2
Acute Pain Management
........................................................................................................................................................
Pain
.........................................................................................................................................................................................................................
Acute Pain
...................................................................................................................................................................................................
Pain Assessment
..............................................................................................................................................................................
Pain Management
..........................................................................................................................................................................
Pain Management Plan
.........................................................................................................................................................
Interventions for Acute Musculoskeletal Pain
..............................................................................
>References
...............................................................................................................................................................................................................
Chapter
3
Effective Communication
........................................................................................................................................................
Communication
...................................................................................................................................................................................
Medical Terminology
.................................................................................................................................................................
Learning Methods
..........................................................................................................................................................................
Factors Affecting Communication
.......................................................................................................................
Evidence Review
..............................................................................................................................................................................
Research Priorities
.......................................................................................................................................................................
>References
...............................................................................................................................................................................................................
Chapter
4
Acute Low Back Pain
......................................................................................................................................................................
Definition of Acute Low Back Pain
....................................................................................................................
Scope
...................................................................................................................................................................................................................
Guideline Development Process
...........................................................................................................................
Research Agenda for Acute Low Back Pain
.....................................................................................
Summary of Key Messages
.............................................................................................................................................
DIAGNOSIS
..................................................................................................................................................................................................................
>Aetiology and Prevalence
..............................................................................................................................................................
Conditions Associated with Acute Low Back Pain:
Radiological Findings
................................................................................................................................................................
>History
..............................................................................................................................................................................................................................
Pain History
...............................................................................................................................................................................................
Clinical Features of Specific Conditions
...................................................................................................
Alerting Features of Serious Conditions (see Table 4.6)
......................................
>Physical Examination
..............................................................................................................................................................................
Physical Assessment
................................................................................................................................................................
Psychosocial Assessment
...............................................................................................................................................
Neurological Assessment
.................................................................................................................................................
v
Contents
>Ancillary Investigations
......................................................................................................................................................................
Imaging
.............................................................................................................................................................................................................
Other Investigations
....................................................................................................................................................................
>Terminology
.............................................................................................................................................................................................................
Diagnostic Terms
.............................................................................................................................................................................
PROGNOSIS
................................................................................................................................................................................................................
Natural History
.....................................................................................................................................................................................
Prognostic Risk Factors
........................................................................................................................................................
INTERVENTIONS
................................................................................................................................................................................................
Evidence of Benefit
......................................................................................................................................................................
Conflicting Evidence
...................................................................................................................................................................
Insufficient Evidence
.................................................................................................................................................................
>Economic Implications
.........................................................................................................................................................................
>References
...............................................................................................................................................................................................................
Chapter
5
Acute Thoracic Spinal Pain
.....................................................................................................................................................
Definition of Acute Thoracic Spinal Pain
................................................................................................
Scope
...................................................................................................................................................................................................................
Guideline Development Process
...........................................................................................................................
Research Agenda for Acute Thoracic Spinal Pain
.................................................................
DIAGNOSIS
..................................................................................................................................................................................................................
>Aetiology and Prevalence
..............................................................................................................................................................
Serious Conditions
........................................................................................................................................................................
Mechanical Conditions
..........................................................................................................................................................
Conditions Referring Pain to the Thoracic Spine
.......................................................................
Conditions Referring Pain from the Thoracic Spine
..............................................................
Prevalence of Conditions Causing Acute Thoracic Spinal Pain
.......................
>History
..............................................................................................................................................................................................................................
Pain History
...............................................................................................................................................................................................
>Physical Examination
..............................................................................................................................................................................
Inspection
.....................................................................................................................................................................................................
Palpation
........................................................................................................................................................................................................
Movement
....................................................................................................................................................................................................
Alerting Features of Serious Conditions (see Table 5.7)
......................................
>Ancillary Investigations
......................................................................................................................................................................
Plain Radiography
..........................................................................................................................................................................
Computed Tomography (CT) Scanning
........................................................................................................
Magnetic Resonance Imaging (MRI)
.............................................................................................................
Other Investigations
....................................................................................................................................................................
Cost Effectiveness of Investigations
...............................................................................................................
>Terminology
.............................................................................................................................................................................................................
Recommended Terms
...............................................................................................................................................................
PROGNOSIS
................................................................................................................................................................................................................
Natural History
.....................................................................................................................................................................................
Influence of Risk Factors and Diagnostic
and Therapeutic Interventions
..................................................................................................................................
INTERVENTIONS
................................................................................................................................................................................................
Evidence of Benefit
......................................................................................................................................................................
Other Treatment
.................................................................................................................................................................................
>References
...............................................................................................................................................................................................................
vi
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