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Latest & greatest articles for low back pain
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The effect of an integrated multidisciplinary rehabilitation programme alternating inpatient interventions with home-based activities for patients with chronic lowbackpain: a randomized controlled trial To compare the effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme in patients with chronic lowback pain.A single-centre, pragmatic, two-arm parallel, randomized controlled trial (1:1 ratio).A rheumatology inpatient rehabilitation centre (...) in Denmark.A total of 165 adults (aged ⩾ 18 years) with chronic lowback pain.An integrated rehabilitation programme comprising an alternation of three weeks of inpatient stay and 12 weeks of home-based activities was compared with an existing rehabilitation programme of four weeks of inpatient stay.Patient-reported outcomes were collected at baseline and at the 26-week follow-up. The primary outcome was back-specific disability (Oswestry Disability Index). Secondary outcomes included pain intensity
Ibuprofen Plus Acetaminophen Versus Ibuprofen Alone for Acute LowBackPain: An Emergency Department-based Randomized Study Patients with lowbackpain (LBP) are often treated with nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are modestly effective for LBP, but many patients with LBP continue to suffer despite treatment with these medications. We compared pain and functional outcomes 1 week after emergency department (ED) discharge among patients randomized to a 1-week course (...) LBP educational session prior to discharge. The primary outcome was improvement on the RMDQ between ED discharge and 1 week later. One secondary outcome was pain intensity, as measured on a 4-point descriptive scale (severe, moderate, mild, none) at 1 week.Enrollment began in October 2018. A total of 120 patients met selection criteria and were randomized. Baseline demographic characteristics were comparable between the two groups. By 1 week after the ED visit, patients randomized to ibuprofen
Comparison of intradermal mesotherapy with systemic therapy in the treatment of lowbackpain: A prospective randomized study Musculoskeletal pain such as lowbackpain (LBP) are routinely encountered in the ED and contribute to ED overcrowding. The aim of our study was to compare the efficiency of mesotherapy with systemic therapy in pain control in patients with lumbar disk herniation.We conducted this prospective parallel randomized controlled trial with the patients admitted (...) to the emergency department with lowbackpain related to herniated lumbar disk. Mesotherapy was performed to one group, while intravenous dexketoprofen was administered to the control group. Changes in pain intensity at 15th minute, 30th minute, 60th minute and 24th hours after treatment using Visual Analogue Scale (VAS), need to use analgesic drug within 24 h after treatment, and adverse effect of the treatment methods were compared between groups.The decreases in pain intensity were statistically
LowBackPain in the Emergency Department: Prevalence of Serious Spinal Pathologies and Diagnostic Accuracy of Red Flags - A Systematic Review Very little evidence is available on the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting to the emergency department (ED). This systematic review aims to investigate the prevalence of serious spinal pathologies and the diagnostic accuracy of red flags in patients presenting with lowbackpain
No difference in pressure pain threshold and temporal summation after lumbar spinal manipulation compared to sham: A randomised controlled trial in adults with lowbackpain. Changes in quantitative sensory tests have been observed after spinal manipulative therapy (SMT), particularly in pressure pain thresholds (PPT) and temporal summation (TS). However, a recent systematic review comparing SMT to sham found no significant difference in PPT in patients with musculoskeletal pain. The sham (...) -controlled studies were generally low quality, and conclusions about other quantitative sensory tests could not be made.We aimed to perform a sham-controlled study with the specific objective of investigating changes in PPT and TS short-term after lumbar SMT compared to sham manipulation in people with lowback pain.This was a double-blind randomised controlled trial comparing high-velocity low-amplitude lumbar SMT against sham manipulation in participants with lowbackpain. Primary outcome measures
Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific lowbackpain. To investigate clinical curative effects of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training on chronic nonspecific lower back pain.A total of 60 patients with chronic nonspecific lower backpain in the Outpatient Department were included in this study. These patients were randomly divided into two groups
Comparison of intravenous NSAIDs and trigger point injection for lowbackpain in ED: A prospective randomized study Lowbackpain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused (...) by TrPs.After randomization, NSAID was administered intravenously in group 1 and TPIs were performed as specified by Travell and Simons in group 2. The TrPs were identified with the anamnesis and physical examination Demographic characteristics and vital signs of the patients were recorded. Pain scores were measured with the Visual Analogue Scale (VAS) at admission; and in minutes 5, 10, 15, 30, and 60.There were 32 patients in group 1 and 22 patients in group 2. The demographics, vital signs, and pain
Using Public Cost Information During LowBackPain Visits: A Qualitative Study. Patients desire information about health care costs because they are increasingly responsible for these costs. Public Web sites that offer cost information could inform provider-patient discussions of costs at the point of care.To evaluate tools to facilitate the use of publicly available cost information during clinical visits for lowbackpain (LBP).Qualitative study using individual and group interviews (...) . In contrast, patients valued cost conversations and found the tools useful, and over one half reported intending to use CompareMaine.org during future care decisions.Generalizability was limited by the small number of practices and participants. Lower-than-anticipated participation precluded examination of the effect of the tool on the frequency of cost-of-care conversations.This multicomponent intervention to introduce publicly reported cost information into LBP clinical discussions had low provider
Are opioids effective in the treatment of chronic lowbackpain? Are Opioids Effective in the Treatment of Chronic LowBackPain? – Clinical Correlations Search Are Opioids Effective in the Treatment of Chronic LowBackPain? April 17, 2019 4 min read By Anna Hirsch Peer Reviewed The use of opioid medications for chronic lowbackpain, or for any chronic non-cancer pain complaint, is still a source of controversy in the medical community, with a large divide between the recommendations (...) for these figures comes from the National Health and Nutritional Examination Survey, in which 14.5% of . 5 Previously, the best evidence to support the use of opioids for chronic lowbackpain–and the evidence on which the three organizations based their recommendations–came from a few dozen short-term randomized controlled trials comparing the use of opioids against placebo for the treatment of backpain. A meta-analysis published in 2016 in JAMA Internal Medicine analyzed the results from 13 of these trials
Randomized Trial of Sacroiliac Joint Arthrodesis Compared with Conservative Management for Chronic LowBackPain Attributed to the Sacroiliac Joint Sacroiliac joint pain is increasingly recognized as a cause of lowbackpain. We compared the safety and effectiveness of minimally invasive sacroiliac joint arthrodesis using triangular titanium implants and conservative management in patients with chronic sacroiliac joint pain.This study was a prospective, multicenter randomized controlled trial (...) of adults with chronic sacroiliac joint pain assigned to either conservative management or sacroiliac joint arthrodesis with triangular titanium implants. The study end points included self-rated lowbackpain (visual analog scale [VAS]), back dysfunction (Oswestry Disability Index [ODI]), and quality of life. Ninety percent of subjects in both groups completed the study.Between June 6, 2013, and May 15, 2015, 103 subjects were randomly assigned to conservative management (n = 51) or sacroiliac joint
A multicenter randomized controlled trial on the efficacy of intradiscal methylene blue injection for chronic discogenic lowbackpain: the IMBI study A study published in PAIN in 2010 showed remarkable effects of intradiscal methylene blue (MB) injections compared with placebo on pain intensity in patients with chronic discogenic lowbackpain (CD-LBP). Both groups received lidocaine hydrochloride injections for pain associated with the procedure. We replicated the design of the previously (...) published study and performed a multicenter, double-blind, randomized, placebo-controlled trial to assess whether the extraordinary effects of MB on pain intensity could be confirmed. The primary outcomes were treatment success defined as at least 30% reduction in pain intensity and the Patients' Global Impression of Change 6 months after the intervention. We included 84 patients with CD-LBP of which 14 (35%) in the MB plus lidocaine group showed treatment success compared with 11 (26.8%) in the control
Intra-articular Triamcinolone Versus Hyaluronate Injections for LowBackPain With Symptoms Suggestive of Lumbar Zygapophyseal Joint Arthropathy: A Pragmatic, Double-Blind Randomized Controlled Trial. The aim of the study was to compare hyaluronate with triamcinolone injections in treating chronic lowbackpain suggestive of lumbar zygopophyseal joint arthropathy.This was a prospective, double-blind, randomized controlled trial. Thirty subjects were randomly assigned to receive bilateral L3-S1 (...) = 52-99.5], P < 0.001). Medians and quartiles were used in statistical analysis when data did not pass normality.Patients with chronic lowbackpain suggestive of lumbar lumbar zygopophyseal joint arthropathy responded similarly to triamcinolone or hyaluronate injections. Synvisc-One group showed significant short- and long-term functional improvement and short-term pain improvement; KA group showed only significant short-term functional benefit and no significant short- or long-term pain
Video-Game-Based Exercises for Older People With Chronic LowBackPain: A Randomized Controlledtable Trial (GAMEBACK) Video game technology increases adherence to home exercise and could support self-management for older people with chronic lowbackpain (LBP).The objective was to investigate the effects of home-based video game exercises on pain self-efficacy and care-seeking in older people with chronic LBP.The study was a randomized controlled trial.The setting was a community and waiting (...) list.Sixty participants, aged > 55 years with chronic LBP, were randomized (1:1) to Wii Fit U exercises or to continue their usual activities for 8 weeks.The intervention was home-based Wii Fit U flexibility, strengthening, and aerobic exercises for 60 minutes, 3 times per week, with fortnightly calls from a physical therapist.Measurements included pain self-efficacy and care-seeking (primary outcomes), and physical activity, pain, function, disability, fear of movement/reinjury, falls efficacy
Evaluation of the Neuropathic Component of Chronic LowBackPain Assessment of neuropathic pain in chronic lowback syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various chronic lowbackpain syndromes using a range of diagnostic tests.Included in this study were 63 patients with chronic axial lowbackpain (ALBP), 48 patients with chronic radicular (...) with sensory loss confirmed by QST was lowest in the ALBP subgroup (23.8%) compared with CDRS (47.8%), and LSS (68.0%) subgroups (P<0.001). A reduction in IENFD was disclosed in a proportion of up to 52.0% of affected roots in patients with CRS.Neuropathic pain is quite frequent in CRS, and QST reveals sensory loss as a frequent abnormality in patients with CRS. Using a cut-off value of 19, PDQ identified a neuropathic component in a relatively low proportion of patients with CRS. CRS may be associated
Discogenic lowbackpain Discogenic lowbackpain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Discogenic lowbackpain Last reviewed: February 2019 Last updated: January 2019 Summary Magnetic resonance imaging is the imaging study of choice for degenerative disc disease due to its unique detail on the representation of the disc status. Other tests may include plain radiographs, computed tomography scanning (...) , or provocative discography. Non-surgical treatments include lifestyle measures, followed by the judicious use of medications, physiotherapy, and therapeutic needling procedures. Surgical treatment includes decompression of neural structures and, in selected patients, a fusion of the motion segment. Definition A complex, multi-factorial, clinical condition characterised by lowbackpain with or without the concurrence of radicular lower limb symptoms in the presence of radiologically-confirmed degenerative
Answer to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic lowbackpain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Sp 31399848 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Answer (...) to the letter to the editor of Y. Li et al. concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic lowbackpain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2224 10.1007/s00586-019-06063-5 Fischgrund Jeffrey S JS Oakland University William Beaumont School of Medicine, 3535 West 13 Mile Road, Suite 744, Royal Oak, MI, 48073, USA. firstname.lastname@example.org. eng Letter 2019 08 09 Germany
Effects of motor control exercise and patient education program in the management of chronic lowbackpain among community-dwelling adults in rural Nigeria: a study protocol for a randomized clinical trial. The impact of chronic lowbackpain (CLBP) is disproportionally higher in rural Nigeria than in urban areas but lack access to rehabilitation. While exercise and education are commonly advocated interventions for the rehabilitation of CLBP, there is a paucity of community-based randomized (...) to one of three intervention arms; MCE plus PE, MCE, or PE groups. The MCE will be administered twice a week for 8 weeks while the PE will be provided once a week for 8 weeks. Participants will be assessed pre-intervention, immediately post-intervention and at 3-month post-intervention. Primary outcomes will be pain intensity and functional disability. Secondary outcomes will be quality of life, fear-avoidance beliefs, pain catastrophizing, back beliefs, global perceived recovery, and physical
Letter to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic lowbackpain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156 31309332 2019 08 30 1432-0932 28 9 2019 Sep European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J Letter (...) to the Editor concerning "Intraosseous basivertebral nerve ablation for the treatment of chronic lowbackpain: a prospective randomized double-blind sham-controlled multi-center study" by Fischgrund JS, et al. [Eur Spine J; (2018) 27(5): 1146-1156]. 2223 10.1007/s00586-019-06061-7 Li Yongchao Y Department of Orthopaedics, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China. Feng Xiaofei X Department of Orthopaedics, Shanghai East Hospital, Tongji University