PM & R : the journal of injury, function, and rehabilitation
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To primarily explore differences in global and regional white matter hyperintensities (WMH) in older adults with self-reported disabling and nondisabling chronic low back pain (CLBP) and to examine the association of WMH with gait speed in all participants with CLBP. To secondarily compare WMH of the participants with CLBP with the pain-free controls. ⋯ Our findings suggest that WMH is associated with, and hence, may be accelerated by chronic pain manifesting as perceived disability, given the self-reported disabled CLBP patients had the greatest burden, and the pain free the least, and manifesting as measurable disability, given increasing WMH was associated with decreasing gait speed in all chronic pain participants.
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Lumbar spinal stenosis has evolved from an anatomic concept to a poorly defined clinical syndrome. Rules for such a syndrome need to be informed by the experience and beliefs of expert clinicians. The level of certainty is seldom considered in defining criteria for a syndrome. ⋯ A recursive approach to diagnostic certainty is valuable. Within 5 questions, clinicians become almost 90% certain that a person has clinical spinal stenosis. This question set provides one pragmatic clinical criterion for the syndrome of lumbar spinal stenosis.