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Opioid treatment for chronic low back pain increases the risk for lifetime illicit drug use [101] and the effect of long-term use of opioids for lower back pain is unknown. [102] For older people with chronic pain, opioids may be used in those for whom NSAIDs present too great a risk, including those with diabetes, stomach or heart problems.
Williams, Paul C. (1974), Low Back and Neck Pain: Causes and Conservative Treatment, Ed 3; Springfield:Charles C Thomas; 78 pages. Williams P, (1955), "Examination and conservative treatment for disc lesions of the lower spine", Clinical Orthopaedics and Related Research 528-40.
There is only weak evidence for the effectiveness of the method's use for treating lower back pain. [8] A 2019 systematic review found that there was evidence that it could reduce chronic lower back pain in the short term, and enhance function in the longer term, but that most studies of the treatment had methodological flaws, such as small sample sizes and a lack of blinding.
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[1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, [2] it has been described as time-consuming and alternatives have been proposed. [3]
"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .
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