{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:39:01Z","timestamp":1762299541443,"version":"build-2065373602"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Resumo<\/jats:title>\n                  <jats:p>A dor lombar (DL) \u00e9 uma condi\u00e7\u00e3o cl\u00ednica muito prevalente no mundo. Cerca de 90% dos casos s\u00e3o classificados como lombalgias inespec\u00edficas, pois n\u00e3o h\u00e1 altera\u00e7\u00f5es anatomopatol\u00f3gicas que justifiquem sua dor. Para uma abordagem terap\u00eautica mais assertiva, \u00e9 preciso identificar as bandeiras vermelhas ou amarelas, bem como diagnosticar o padr\u00e3o de dor (nociceptiva, neurop\u00e1tica, nocipl\u00e1stica ou mista) desses pacientes. Nas lombalgias agudas, a evolu\u00e7\u00e3o natural \u00e9 favor\u00e1vel na maioria das vezes, e o objetivo do tratamento \u00e9 evitar a sua cronifica\u00e7\u00e3o. Nos casos das lombalgias cr\u00f4nicas, visamos a diminui\u00e7\u00e3o da dor, e a melhora da funcionalidade e da qualidade de vida. Tanto nos casos agudos quanto cr\u00f4nicos, guiamos nossas condutas pelo princ\u00edpio da analgesia multimodal, que combina medidas farmacol\u00f3gicas, n\u00e3o farmacol\u00f3gicas e intervencionistas contra a dor. Entre os medicamentos mais utilizados est\u00e3o analg\u00e9sicos simples, como o paracetamol, relaxantes musculares, anti-inflamat\u00f3rios n\u00e3o esteroidais (AINEs) e os analg\u00e9sicos opioides. Os AINEs e os opioides, quando indicados, devem ser prescritos na menor dose e pelo menor tempo poss\u00edvel. As medica\u00e7\u00f5es adjuvantes est\u00e3o indicadas na presen\u00e7a do componente neurop\u00e1tico. Os fitocanabinoides s\u00e3o possibilidade quando as drogas anteriores falham. Medidas f\u00edsicas, como calor, laser e terapia de ondas de choque extracorp\u00f3rea, melhoram a circula\u00e7\u00e3o local, produzem relaxamento muscular e tratam o componente miofascial. Interven\u00e7\u00f5es como acupuntura e radiofrequ\u00eancia promovem neuromodula\u00e7\u00e3o perif\u00e9rica e\/ou central. Alinhar a expectativa do paciente aos resultados dos tratamentos propostos \u00e9 fundamental; para isso, devemos considerar as medidas educacionais, terapias comportamentais e a reabilita\u00e7\u00e3o f\u00edsica.<\/jats:p>","DOI":"10.1055\/s-0045-1810405","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:33:10Z","timestamp":1762299190000},"page":"001-007","source":"Crossref","is-referenced-by-count":0,"title":["Atualiza\u00e7\u00e3o sobre os tratamentos n\u00e3o cir\u00fargicos para a dor lombar"],"prefix":"10.1055","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1867-7004","authenticated-orcid":false,"given":"Andr\u00e9 Wan Wen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, 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