Scandinavian journal of rheumatology
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Scand. J. Rheumatol. · Jan 2004
Randomized Controlled Trial Multicenter Study Clinical TrialEtoricoxib reduced pain and disability and improved quality of life in patients with chronic low back pain: a 3 month, randomized, controlled trial.
Chronic low back pain (LBP) is a growing health problem. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat this condition, but have not demonstrated efficacy beyond 2 weeks, and no studies have shown that NSAIDs produce durable improvements in disability. ⋯ Etoricoxib provided significant relief of symptoms and disability associated with chronic LBP detected at 1 week, confirmed at 4 weeks, and maintained over 3 months. Reductions in chronic LBP severity corresponded to improvements in physical functioning and quality of life. All treatments were generally well tolerated.
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Scand. J. Rheumatol. · Jan 2004
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy and tolerability of intravenous tropisetron in the treatment of fibromyalgia.
To determine the efficacy of a serotonin receptor (5-HT(3)) antagonist in the treatment of fibromyalgia (FM) in a prospective, randomized, double-blind, placebo-controlled, multicentre trial. ⋯ 5-HT(3) receptor antagonists provide significant pain relief for a group of FM patients.
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Scand. J. Rheumatol. · Jan 2004
Review Comparative StudyPrevalence and incidence of shoulder pain in the general population; a systematic review.
To investigate the incidence and prevalence of shoulder complaints in the general population. ⋯ The reported prevalence figures on shoulder complaints diverged strongly. Health professionals and policymakers who estimate the amount of medical care needed and related costs should be aware of the variations in prevalence rate and the underlying reasons for these differences.
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Scand. J. Rheumatol. · Jan 2004
ReviewStabilisation surgery for chronic low back pain: indications, surgical procedures, and outcome.
Spinal fusion was introduced as a treatment option for chronic low back pain >70 years ago. However, few areas of spinal surgery have caused as much controversy. The debate about whether to use an anterior-, posterior- or anterior + posterior approach has persisted since the 1930s. ⋯ Two recent RCTs have dealt with the question of conservative versus operative treatment of patients with low back pain, and both studies have shown a significant better functional outcome for spinal fusion in situ, compared with a more or less organized exercise programme at 2-year follow-up. The choice of postoperative rehabilitation strategy has also been shown to be of importance for overall functional outcome. One study has demonstrated the importance of the inclusion of coping schemes, and questioned the role of intensive exercises in a rehabilitation programme for spinal fusion patients.
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Low back pain seems to be an integral part of most human lives and cause different degrees of suffering and disability. The exact cause of the pain cannot be identified in most instances. The making of the diagnosis rests mainly on the patient's history, location, and duration of the pain. ⋯ The natural history of low back pain seems in general to be favourable, but of concern is the consequence of long term or permanent disability. Fear avoidance behaviour has been shown to be part of the disabling pathway in chronic low back pain. Cognitive interventions, designed to remove fear and uncertainty, and to give the patient the confidence that the back is robust even if it hurts, seem promising.