Hopp til hovedinnhold

Korsryggsmerte, langvarig

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Ryggsmerter av mer enn 3 måneders varighet. Kan skyldes for eksempel uheldig arbeidsstilling eller akutt belastning og kan opprettholdes eller forverres av psykososiale årsaker
Forekomst:
60-70% av befolkningen vil oppleve ryggsmerter en eller flere ganger i løpet av livet
Symptomer:
Lave ryggsmerter. Alarmsymptomer kan gi mistanke om alvorlig underliggende patologi
Funn:
Varierende funn avhengig av årsak og grad av smerter. Generelt nedsatt bevegelighet i alle plan, stram muskulatur og ømhet ved trykk både mot ryggvirvler og paravertebral muskulatur.
Diagnostikk:
Supplerende undersøkelser er vanligvis ikke nødvendig dersom det ikke foreligger røde flagg (alarmsymptomer)
Behandling:
Hovedprinsipp for behandling er i størst mulig grad å trosse smertene og opprettholde normal aktivitet
  1. Nasjonal faglig retningslinje for bildediagnostikk ved ikke-traumatiske muskel- og skjelettlidelser. Anbefalinger for primærhelsetjenesten. Oslo, Helsedirektoratet 2014. www.helsebiblioteket.no  
  2. Formidlingsenheten for muskel- og skjelettlidelser. Nasjonale kliniske retningslinjer. Korsryggsmerter - med og uten nerverotaffeksjon. Sosial- og helsedirektoratet, 2007.
  3. Will JS, Bury DC, Miller JA. Mechanical Low Back Pain. Am Fam Physician. 2018 Oct 1;98(7):421-428. PMID: 30252425. PubMed  
  4. Munk R, Storheim K, Zwart J-A, et al. Mens vi venter på nye retningslinjer for behandling av korsryggsmerter. Tidsskr Nor Legeforen, publisert 20. mai 2020. doi: 10.4045/tidsskr.20.0181 DOI  
  5. Hill JC, Whitehurst DGT, Lewis M, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet 2011; 378: 1560-71. PubMed  
  6. Suri P, Delaney K, Rundell SD, et al. Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting. Arch Phys Med Rehabil. 2018; 99:1533-1539. PMID: 29625095 PubMed  
  7. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379(9814):482–491.
  8. Freburger JK, Holmes GM, Agans RP, et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009;169(3):251-258 . doi:10.1001/archinternmed.2008.543 DOI  
  9. E Iordanova, C Røe, A Keller,et al. Langvarige korsryggssmerter og MR-forandringer i ryggvirvlene. Tidsskr Nor Legeforen 2010; 130: 2260-3. doi:10.4045/tidsskr.09.0122 DOI  
  10. Chou D, Samartzis D, Bellabarba C, et al. Degenerative magnetic resonance imaging changes in patients with chronic low back pain: a systematic review. Spine (Phila Pa 1976) 2011; 36: S43-53. pmid:21952189 PubMed  
  11. Andrade NS, Ashton CM, Wray NP, et al. Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis. Eur Spine J 2015; 24: 1289-95. pmid:25833204 PubMed  
  12. Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry. Published online September 29, 2021. PMID: 34586357 PubMed  
  13. Hartvigsen J, Hancock MJ, Kongsted A et al. What low back pain is and why we need to pay attention. Lancet 2018; 391: 2356–67. PMID: 29573870 PubMed  
  14. Jacobsen S, Gosvig KK, Sonne-Holm S. Lænderyggens degeneration og radiologi. Ugeskr Læger 2006; 168: 769-73. PubMed  
  15. Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010; 6: CD007612. Cochrane (DOI)  
  16. Rubinstein SM, de Zoete A, van Middelkoop M, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ 2019; 364: l689. pmid:30867144 PubMed  
  17. Kwan-Yee Ho EK, Chen L, Simic M, et al. Psychological interventions for chronic, non-specific low back pain: Systematic review with network meta-analysis. BMJ 2022 Mar 30; 376:e067718. PMID: 35354560 PubMed  
  18. Werner EL, Storheim K, Løchting I, Wisløff T, Grotle M. Cognitive Patient Education for Low Back Pain in Primary Care: A Cluster Randomized Controlled Trial and Cost-Effectiveness Analysis. Spine (Phila Pa 1976) 2016; 41: 455-62. pmid:26966970 PubMed  
  19. Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2016; 176: 199-208. doi:10.1001/jamainternmed.2015.7431 DOI  
  20. Schaafsma FG, Whelan K, van der Beek AJ, et al. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD001822. DOI: 0.1002/14651858.CD001822.pub3 Cochrane (DOI)  
  21. Tan L, Cicuttini FM, Fairley J, et al. Does aerobic exercise effect pain sensitisation in individuals with musculoskeletal pain? A systematic review. BMC Musculoskelet Disord. 2022;23:113. PMID: 35114987 PubMed  
  22. Hayden J, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD000335. DOI: 10.1002/14651858.CD000335.pub2 DOI  
  23. Aleksiev AR. Ten-year follow-up of strengthening versus flexibility exercises with or without abdominal bracing in recurrent low back pain. Spine 2014; 39: 997-1003 PMID: 24732860 PubMed  
  24. Kolber MR, Ton J, Thomas B et al.PEER systematic review of randomized controlled trials: Management of chronic low back pain in primary care. Can Fam Physician. 2021 Jan;67(1):e20-e30. PMID: 33483410 PubMed  
  25. Smith BE, Littlewood C, May S. An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord. 2014 Dec 9;15:416. doi: 10.1186/1471-2474-15-416.
  26. Foster NE, Anema JR, Cherkin D et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018; 391: 2368–83. PMID: 29573872 PubMed  
  27. Enthoven WTM, Roelofs PDDM, Deyo RA, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD012087. DOI: 10.1002/14651858.CD012087. DOI  
  28. Wong JJ, Côté P, Ameis A, wt al. Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Spin 2016; 25: 34-61. pmid:25827308 PubMed  
  29. Enthoven WTM, Roelofs PDDM, Deyo RA, et al. Non‐steroidal anti‐inflammatory drugs for chronic low back pain. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD012087. DOI: 10.1002/14651858.CD012087. DOI  
  30. Urquhart DM, Wluka AE, van Tulder M, et al. Efficacy of low-dose amitriptyline for chronic low back pain. A randomized clinical trial. JAMA Intern Med 2018. pmid:30285054 PubMed  
  31. Urquhart DM, Hoving JL, Assendelft WJJ, Roland M, van Tulder MW. Antidepressants for non-specific low back pain. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001703. DOI: 10.1002/14651858.CD001703.pub3 DOI  
  32. Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ 2015; 350: h1225. doi:10.1136/bmj.h1225 DOI  
  33. Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004959. DOI: 10.1002/14651858.CD004959.pub4 DOI  
  34. Helsedirektoratet (2021). Nasjonal veileder for vanedannende legemidler nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 19. oktober 2021, lest 29. oktober 2021).
  35. Enke O, New HA, New CH, et al. Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ 2018; 190: E-786-E793. pmid:29970367 PubMed  
  36. Shanthanna H, Gilron I, Rajarathinam M, et al. Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. Plos Med 2017. doi:10.1371/journal.pmed.1002369 DOI  
  37. Read SH, Giannakeas V, Pop P, et al. Evidence of a gabapentinoid and diuretic prescribing cascade among older adults with lower back pain. J Am Geriatr Soc 2021; 69: 2842-50. pmid:34118076 PubMed  
  38. Wilkens P, Scheel IB, Grundnes O, Hellum C, Storheim K. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthitis. JAMA 2010; 304: 45-52. Journal of the American Medical Association  
  39. Bråten LCH, Rolfsen MP, Espeland A et al. Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial.. BMJ 2019; 367: I5654. pmid:31619437 PubMed  
  40. Albert HB, Sorensen JS, Christensen BS, Manniche C. Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J. 2013 ;22(4):697-707. PMID: 23404353. PubMed  
  41. Bråten LCH, Grøvle L, Espeland A, et al. Clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes - secondary analyses of a randomised, placebo-controlled trial (the AIM study). BMC Musculoskelet Disord 2020; 13: 458. pmid:32660517 PubMed  
  42. Rubinstein SM, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD008112. DOI: 10.1002/14651858.CD008112.pub2. DOI  
  43. Walker BF, French SD, Grant W, Green S. Combined chiropractic interventions for low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 4. Art. No.: CD005427. DOI: 10.1002/14651858.CD005427.pub2 DOI  
  44. Licciardone JC, Minotti DE, Gatchel RJ, et al. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med 2013; 11: 122-9. pmid:23508598 PubMed  
  45. Frost H, Lamb SE, Doll HA, Carver PT, Stewart-Brown S. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ 2004; 329: 708-11. British Medical Journal  
  46. Ebadi S, Henschke N, Nakhostin et al. Therapeutic ultrasound for chronic low-back pain. Cochrane Database Syst Rev. 2014;3:CD009169. doi: 10.1002/14651858.CD009169.pub2. The Cochrane Library  
  47. van Dillen LR, Lanier VM, Steger-May K, et al. Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain A Randomized Clinical Trial. JAMA Neurol 2021; 78: 385-95. pmid:33369625 PubMed  
  48. Rivero-Arias O, Gray A, Frost H, Lamb SE, Stewart-Brown S. Cost-utility analysis of physiotherapy treatment compared with physiotherapy advice in low back pain. Spine 2006; 31: 1381-7. PubMed  
  49. Furlan AD, Giraldo M, Baskwill A, et al. Massage for low‐back pain. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001929. DOI: 10.1002/14651858.CD001929.pub3. DOI  
  50. Wegner I, Widyahening IS, van Tulder MW, Blomberg SEI, de Vet HCW, Brønfort G, Bouter LM, van der Heijden GJ. Traction for low-back pain with or without sciatica. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD003010. DOI: 10.1002/14651858.CD003010.pub5 DOI  
  51. Clare HA, Adams R, Maher CG. A systematic review of efficacy of McKenzie therapy for spinal pain. Aust J Physiother 2004; 50: 209-16. PubMed  
  52. Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD003008. DOI: 10.1002/14651858.CD003008.pub3 DOI  
  53. Friedrich M , et al. Long-term effect of a combined exercise and motivational program on the level of disability of patients with chronic low back pain. Spine 2005; 30: 995-1000. PubMed  
  54. Natour J, Cazotti LD, Ribeiro LH, et al. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2014. PMID: 24965957 PubMed  
  55. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-747. PubMed  
  56. Karshikoff B, Jensen KB, Kosek E, et al Why sickness hurts: a central mechanism for pain induced by peripheral inflammation. Brain Behav Immun. 2016;57:38-46. PubMed  
  57. Nicholas M, Vlaeyen JWS, Rief W, et al; IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain. 2019;160(1):28-37. PubMed  
  58. Clauw DJ. Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s). Best Pract Res Clin Rheumatol. 2015;29(1):6-19. PubMed  
  59. Henschke N, Ostelo RWJG, van Tulder MW, Vlaeyen JWS, Morley S, Assendelft WJJ, Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD002014. DOI: 10.1002/14651858.CD002014.pub3. DOI  
  60. Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001351. DOI: 10.1002/14651858.CD001351.pub2. DOI  
  61. Parreira P, Heymans MW, van Tulder MW, Esmail R, Koes BW, Poquet N, Lin CWC, Maher CG. Back Schools for chronic non‐specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD011674. DOI: 10.1002/14651858.CD011674.pub2. DOI  
  62. Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis: Acupuncture for low back pain. Ann Intern Med 2005; 142: 651-63. Annals of Internal Medicine  
  63. Ratcliffe J, Thomas KJ, MacPherson H, Brazier J. A randomised controlled trial of acupuncture care for lower back pain: cost effectiveness analysis. BMJ 2006; 333; 623.
  64. Little P, Lewith G, Webley F et al. Randomised controlled trail of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and reccurent back pain. BMJ 2008; 337: a884. PubMed  
  65. Engers AJ, Jellema P, Wensing M, van der Windt DAWM, Grol R, van Tulder MW. Individual patient education for low back pain. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004057. DOI: 10.1002/14651858.CD004057.pub3 DOI  
  66. Herman PM, Anderson ML, Sherman KJ, et al. Cost-effectiveness of Mindfulness-based Stress Reduction Versus Cognitive Behavioral Therapy or Usual Care Among Adults With Chronic Low Back Pain. Spine (Phila Pa 1976). 2017. PMID: 28742756 PubMed  
  67. Cramer H, Lauche R, Haller H, Dobos G. A systematic review and meta-analysis of yoga for low back pain. Clin JPain 2013; 29: 450-60. pmid: 23246998 PubMed  
  68. Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017; 1: CD010671. pmid:28076926 PubMed  
  69. Wells C, Kolt GS, Marshall P, et al. The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review. PLoS One. 2014; Jul 1;9(7): 100402. pmid:24179139 PubMed  
  70. Patti A, Bianco A, Paoli A, et al. Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine (Baltimore). 2015;94(4):e383. PMID: 25634166 PubMed  
  71. Yamato TP, Maher CG, Saragiotto BT, et al. Pilates for low back pain. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD010265. DOI: 10.1002/14651858.CD010265.pub2 DOI  
  72. French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. Superficial heat or cold for low back pain. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004750. DOI: 10.1002/14651858.CD004750.pub2. The Cochrane Library  
  73. MacRae CS, Lewis JS, Shortland AP, et al. Effectiveness of rocker sole shoes in the management of chronic low back pain: a randomized clinical trial. Spine 2013; 38: 1905-12. doi:10.1097/BRS.0b013e3182a69956 DOI  
  74. Gibson JNA, Waddell G. Surgery for degenerative lumbar spondylosis. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD001352. DOI: 10.1002/14651858.CD001352.pub3. DOI  
  75. Christensen FB, Bunger C. Stabilisation surgery for chronic low back pain: indications, surgical procedures and outcome. Scand J Rheumatol 2004; 33: 210-7. PubMed  
  76. Fairbank J, Frost H, Wilson-MacDonald J, Yu LM, Barker K, Collins R, for the Spine Stabilisation Trial Group. Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ 2005; 330:1220-27. British Medical Journal  
  77. Bjerkeset T, Johnsen LG, Kibsgaard L et al. Kirurgisk behandling av degenerative korsryggslidelser Tidsskr Nor Lægeforen 2005; 125: 1817-9. PubMed  
  78. Brox JI, Reikeras O, Nygaard O, et al. Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: A prospective randomized controlled study. Pain 2006; 122: 145-55. PubMed  
  79. Rognsvåg T, Strand LI, Skouen JS. Smerte- og funksjonsforløp hos pasienter med lumbal skiveprotese. Tidsskr Nor Lægeforen 2007; 127: 1188-91. PubMed  
  80. Hellum C, Johnsen LG, Storheim K, et al. Surgery with disc prosthesis versus rehabilitation in patients with low back pain and degenerative disc: two year follow-up of randomised study. BMJ 2011; 342: d2786. BMJ (DOI)  
  81. Jacobs W, Van der Gaag NA, Tuschel A, de Kleuver M, Peul W, Verbout AJ, Oner FC. Total disc replacement for chronic back pain in the presence of disc degeneration. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD008326. DOI: 10.1002/14651858.CD008326.pub2 DOI  
  82. Staal JB, de Bie R, de Vet HCW, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD001824. pmid: 18646078 PubMed  
  83. Nguyen C, Boutron I, Baron G et al. Intradiscal Glucocorticoid Injection for Patients With Chronic Low Back Pain Associated With Active Discopathy: A Randomized Trial. Ann Intern Med. 2017 Mar 21. Epub ahead of print pmid: 28319997 PubMed  
  84. Waseem Z, Boulias C, Gordon A, Ismail F, Sheean G, Furlan AD. Botulinum toxin injections for low-back pain and sciatica. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD008257. DOI: 10.1002/14651858.CD008257.pub2. DOI  
  85. Hooten WM, Cohen SP. Evaluation and Treatment of Low Back Pain: A Clinically Focused Review for Primary Care Specialists. Mayo Clin Proc. 2015 Dec;90(12):1699-718. pmid: 26653300. PubMed  
  86. Maas ET, Ostelo RWJG, Niemisto L, Jousimaa J, Hurri H, Malmivaara A, van Tulder MW. Radiofrequency denervation for chronic low back pain. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD008572. pmid: 26495910 PubMed  
  87. U.S. Preventive Services Task Force. Brief evidence update: primary care interventions to prevent low back pain. Accessed January 10, 2007, at: http://www.ahrq.gov/clinic/3rduspstf/lowback/lowbackup.htm.
  88. Burton AK, Balague F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, et al., for the COST B13 Working Group on European Guidelines for Prevention in Low Back Pain. How to prevent low back pain. Best Pract Res Clin Rheumatol 2005; 19: 541-55. PubMed  
  89. Bigos SJ, Holland J, Holland C, et al. High-quality controlled trials on preventing episodes of back problems: systematic litterature review in working-age adults. Spine 2009; 9: 147-68. PubMed  
  90. Buchbinder R, Jolley D, Wyatt M. Population based intervention to change back pain beliefs and disability: three part evaluation . BMJ 2001; 322: 1516-20. PubMed  
  91. Carragee EJ, Hannibal M. Diagnostic evaluation of low back pain. Orthop Clin North Am 2004; 35: 7-16. PubMed  
  92. Pengel LHM, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ 2003; 327: 323-8. British Medical Journal  
  93. Costa LCM, Maher CG, McAuley JH, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ 2009; 339: b3829. BMJ (DOI)  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Redaksjonsmedarbeider NHI/ overlege Barne- og ungdomsklinikken, St. Olavs Hospital
  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo
  • Even Lærum, professor i allmennmedisin, Institutt for samfunnsmedisinske fag, Universitetet i Oslo
  • Magne Rø, overlege Fysikalsk medisinsk avdeling, Regionsykehuset i Trondheim, og førsteamanuensis Norges teknisk-naturvitenskapelige universitet, Trondheim