Course & Progsis The usual course of lumbar strain is spontaneous remission with time. (Relapses) of pain are commonly (precipitated) by stressful activity, though months may pass without symptoms. Some patients complain of constant pain without real remission. Probing inquiry frequently reveals profound depression in these individuals, for whom illness and disability have become (dominant) elements in their lives. When strain is attributed to working conditions, the clinical course may be complicated by considerations of secondary gain. Patients who fail to respond to rest and supportive measures must be carefully reexamined to (rule out) development of neurologic compromise. Those who remain neurologically normal must be encouraged to return to normal activities as rapidly as possible. Prolonged reliance upon analgesics must be discourage.
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