Chapter 016. Back and Neck Pain (Part 11)

Psychiatric DiseaseCLBP may be encountered in patients who seek financial compensation; in malingerers; or in those with concurrent substance abuse, chronic anxiety states, or depression. Many patients with CLBP have a history of psychiatric illness (depression, anxiety, substance abuse) or childhood trauma (physical or sexual abuse) that antedates the onset of back pain. Preoperative psychological assessment has been used to exclude patients with marked psychological impairments that predict a poor surgical outcome.Unidentified The cause of low back pain occasionally remains unclear. Some patients have had multiple operations for disk disease but have persistent pain and disability. ...
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Chapter 016. Back and Neck Pain (Part 11) Chapter 016. Back and Neck Pain (Part 11) Psychiatric Disease CLBP may be encountered in patients who seek financial compensation; inmalingerers; or in those with concurrent substance abuse, chronic anxiety states, ordepression. Many patients with CLBP have a history of psychiatric illness(depression, anxiety, substance abuse) or childhood trauma (physical or sexualabuse) that antedates the onset of back pain. Preoperative psychologicalassessment has been used to exclude patients with marked psychologicalimpairments that predict a poor surgical outcome. Unidentified The cause of low back pain occasionally remains unclear. Some patientshave had multiple operations for disk disease but have persistent pain anddisability. The original indications for surgery may have been questionable, withback pain only, no definite neurologic signs, or a minor disk bulge noted on CT orMRI. Scoring systems based upon neurologic signs, psychological factors,physiologic studies, and imaging studies have been devised to minimize thelikelihood of unsuccessful surgery.[newpage] Back Pain: Treatment Acute Low Back Pain (ALBP) ALBP is defined as pain of