### What you need to know Low back pain is the world’s leading cause of disability.1 At any time, half a billion (9%) adults are affected.1 Many are prescribed, or use, analgesics for pain relief.2 In this article, we review what is known about common analgesics for treating non-specific low back pain (defined as pain without an identifiable structural or disease cause). We focus on adults aged 18-60 years. A previous BMJ education paper describes the management of low back pain in people aged 60 and over, in whom the likelihood of there being a specific cause is greater and the risk-benefit balance of analgesics differs.3 The treatment of radicular low back pain (such as sciatica) has been detailed elsewhere4 and is not addressed here. Low back pain (synonymous with “primary” low back pain) is pain felt between the lower ribs and the buttocks.5 This differs from radicular low back pain, which is when a spinal nerve root is affected, resulting in pain that extends down the legs.6 Approximately 90% of cases are non-specific, meaning a specific cause has not been identified. The causes of the remaining 10%, affecting around <1 in 100 in primary care7 and about 5 in 100 in emergency departments,8 include fractures, infections, malignancies, inflammatory disorders such as spondylarthritis, spinal stenosis, …

中文翻译：

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非特异性腰痛的镇痛


### 您需要了解的内容 腰痛是世界上导致残疾的主要原因。1 任何时候，都有 5 亿 (9%) 成年人受到影响。1 许多人服用或使用镇痛药来缓解疼痛。2在本文中，我们回顾了治疗非特异性腰痛（定义为没有可识别的结构或疾病原因的疼痛）的常用镇痛药的已知信息。我们专注于18-60岁的成年人。之前的 BMJ 教育论文描述了 60 岁及以上人群腰痛的治疗，其中特定原因的可能性更大，镇痛药的风险效益平衡也不同。3 根性腰痛的治疗（例如坐骨神经痛）已在其他地方详细说明4，此处不再赘述。腰痛（与“原发性”腰痛同义）是指下肋骨和臀部之间的疼痛。5 这与神经根性腰痛不同，后者是指脊神经根受到影响，导致疼痛向下延伸至腰部。 6 大约 90% 的病例是非特异性的，这意味着尚未确定具体原因。其余 10% 的原因包括骨折、感染、恶性肿瘤、炎症性疾病，如脊椎关节炎、椎管狭窄等，影响初级保健中大约百分之一的人7，以及急诊科中大约百分之五的人8。