Boyer LE, Boudier-Revéret M, Chang MC. Protocol for lower back pain management: Insights from the French healthcare system. World J Clin Cases 2024; 12(11): 1875-1880 [PMID: 38660557 DOI: 10.12998/wjcc.v12.i11.1875]
Corresponding Author of This Article
Min Cheol Chang, MD, Professor, Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daemyungdong, Namku, Daegu 705-717, South Korea. wheel633@gmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2024; 12(11): 1875-1880 Published online Apr 16, 2024. doi: 10.12998/wjcc.v12.i11.1875
Protocol for lower back pain management: Insights from the French healthcare system
Lea Evangeline Boyer, Mathieu Boudier-Revéret, Min Cheol Chang
Lea Evangeline Boyer, Department of Physical Medicine and Rehabilitation, CHU de la Réunion, Reunion Island CIC 1410, France
Mathieu Boudier-Revéret, Department of Rehabilitation Medicine, University of Montreal Health Center, Montreal, QC H2X 3E4, Canada
Min Cheol Chang, Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daegu 705-717, South Korea
Author contributions: Boyer LE, Boudier-Revéret M and Chang MC designed the study, performed the study, analyzed the data, wrote the manuscript, read and approved the final manuscript.
Supported byThe National Research Foundation of Korea Grant funded by the Korea Government, No. 00219725.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Cheol Chang, MD, Professor, Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daemyungdong, Namku, Daegu 705-717, South Korea. wheel633@gmail.com
Received: February 9, 2024 Peer-review started: February 9, 2024 First decision: March 2, 2024 Revised: March 5, 2024 Accepted: March 22, 2024 Article in press: March 22, 2024 Published online: April 16, 2024 Processing time: 62 Days and 4.1 Hours
Abstract
In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases. This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis. The impact of spinal pain-related disability extends significantly, causing substantial human suffering and medical costs. Each county has its preferred treatment strategies for spinal pain. Here, we explore the lower back pain (LBP) treatment algorithm recommended in France. The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use. It encourages the continuation of daily activities, limits excessive medication and spinal injections, and incorporates psychological assessments and non-pharmacological therapies for chronic cases. However, the algorithm may not aggressively address acute pain in the early stages, potentially delaying relief and increasing the risk of chronicity. Additionally, the recommended infiltrations primarily involve caudal epidural steroid injections, with limited consideration for other injection procedures, such as transforaminal or interlaminar epidural steroid injections. The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain, potentially delaying the exploration of alternative therapies. Despite these limitations, understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally, potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.
Core Tip: The treatment algorithm for low back pain in France, recommended by the French National Authority for Health, prioritizes early patient activity and minimal medication use. While it promotes daily function and non-pharmacological therapies for chronic cases, it may not adequately address acute pain, relying heavily on caudal epidural steroid injections. The fixed follow-up timeline may also hinder exploring alternative therapies for non-responsive or intensely painful cases. Despite these limitations, understanding the strengths and weaknesses of this approach could inform global adaptations, potentially improving patient outcomes and satisfaction across diverse healthcare systems.
