Journal of back and musculoskeletal rehabilitation
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J Back Musculoskelet Rehabil · Jan 2011
Is chronic opioid use a negative predictive factor for response to cervical epidural steroid injections?
Cervical epidural steroid injections (ESIs) are often used to treat patients with neck and upper extremity pain associated with a cervical radiculopathy. The effect of chronic opioid use in cervical radiculopathy patients managed with ESIs is unknown; past studies suggest that these patients may behave differently than opioid naïve patients. The purpose of this study is to determine the effect of chronic (greater than 6 months) opioid use on the immediate outcome of cervical ESIs. ⋯ Patients managed with opioids chronically may respond in a different manner to ESIs when compared to opioid naïve patients.
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J Back Musculoskelet Rehabil · Jan 2011
Case ReportsOsteopoikilosis associated with fibromyalgia and active myofascial trigger point in upper trapezius muscles.
Osteopoikilosis is a sclerosing bone dysplasia, characterized by multiple oval spots of radiodensities within the trabecular bone. It occurs equally common among men and women. ⋯ Most reported cases have been found incidentally on roentgenograms taken for other purposes. We present a 58-year-old woman with OPK associated with fibromyalgia and active myofascial trigger point in upper trapezius muscles.
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J Back Musculoskelet Rehabil · Jan 2011
Evaluation of patients' response to pulsed radiofrequency treatment applied to the suprascapular nerve in patients with chronic shoulder pain.
The aim of this study was to evaluate patient satisfaction, efficacy and safety of the pulsed radiofrequency (PRF) technique applied to the suprascapular nerve for the treatment of refractory shoulder pain. ⋯ Pulsed radiofrequency technique application to the suprascapular nerve for 480 seconds shows remarkable improvement at patients' chronic shoulder pain.
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J Back Musculoskelet Rehabil · Jan 2010
Three-dimensional gait analysis of patients with weakness of ankle dorsiflexor as a result of unilateral L5 radiculopathy.
L5 radiculopathy leads to weakness in ankle dorsiflexor, which can further affect ambulation status. The purpose of this study was to investigate the characteristics of gait patterns associated with L5 radiculopathy. ⋯ The pelvis of intact side was tilted downward due to hip abductor weakness of involved side in the stance phase whereas the pelvis of involved side was tilted upward for foot clearance in the swing phase. This contributed to increase in hip adduction of the involved side through the gait cycle. Eccentric contraction of ankle dorsiflexion that normally occurred in the loading response and the early swing phase was not sufficient and, therefore, ankle dorsiflexion was decreased in these gait cycles.
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J Back Musculoskelet Rehabil · Jan 2010
Case ReportsImportance of fear-avoidance behavior in chronic non-specific low back pain.
International classification of Functioning, Disability and Health has adapted a biopsychosocial model for management of chronic low back pain patient (CLBP). The influence of psychological factors seems to be important in the transition from acute to chronic low back pain (> 3 months). In particular, pain-related fear and pain catastrophizing are believed to be important factors for disability. ⋯ After a few weekly therapeutic sessions of CBT, significant changes were seen in all outcome measures. It has been concluded that probably, by using specific biopsychosocial training, positive results in fear avoidance behavior can be achieved. Hence the psychotherapeutic management approach is considered as a useful economical tool in low back pain.