Prévenir la chronicisation de douleurs rachidiennes

Abstract

Low back pain (LBP) is the leading cause of disability in France and worldwide and is increasing in France and worldwide. The burden is mainly related to chronic low back pain due to its personal, financial and professional repercussions. This article aims to detail the benefits of prevention of low back pain. Screening for people at risk of chronic low back pain is important to identify the most appropriate management. Prevention of LBP can be primary (when no LBP is present), secondary (to reduce the duration of its development) or tertiary (to reduce the prevalence of chronic disability or recurrence). At all stages, physical activity is the best achievable prevention, if possible coupled with information and education based on reassurance. Limiting spinal imaging could also be beneficial for secondary prevention. Prevention and promotion of physical activity is particularly important in two risk situations : occupational situations with heavy or frequently repeated load bearing and pregnancy. Workplace ergonomics has not yet proven to be very effective. Insoles and lumbar belts are not effective in primary or secondary prevention, in the general population or at work.