Joint, bone, spine : revue du rhumatisme
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Randomized Controlled Trial
Total dorsal ramus block for the treatment of chronic low back pain: a preliminary study.
To evaluate the use of total dorsal ramus block, which blocks all three major branches (medial, intermediate, and lateral branches) of lumbar dorsal ramus, for chronic low back pain. ⋯ The results of this preliminary study show that the total dorsal ramus block procedure may sufficiently block all three branches of the lumbar dorsal ramus at the targeted level with significant pain reduction.
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Comparative Study Clinical Trial
The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis.
Knee osteoarthritis (OA) is a common chronic degenerative disorder. There are various treatment modalities. This study was planned to investigate the efficacy of balneotherapy, mud-pack therapy in patients with knee OA. ⋯ Balneotherapy and mud-pack therapy were effective in treating patients with knee OA.
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Review
Spinal muscle evaluation in healthy individuals and low-back-pain patients: a literature review.
This article reviews available techniques for spinal muscle investigation, as well as data on spinal muscles in healthy individuals and in patients with low back pain. In patients with chronic low back pain, medical imaging studies show paraspinal muscle wasting with reductions in cross-sectional surface area and fiber density. In healthy individuals, the paraspinal muscles contain a high proportion of slow-twitch fibers (Type I), reflecting their role in maintaining posture. ⋯ Abnormalities seen in paraspinal muscles from patients with chronic low back pain include marked Type II fiber atrophy, conversion of Type I to Type II fibers, and an increased number of nonspecific abnormalities. Limited data are available from magnetic resonance spectroscopy used to investigate muscle metabolism and from near infrared spectroscopy used to measure oxygen uptake by the paraspinal muscles. Surface electromyography in patients with chronic low back pain shows increased paraspinal muscle fatigability, often with abolition of the flexion-relaxation phenomenon.
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Previously known only as a deadly bacterial poison responsible for severe paralysis, botulinum toxin is now a well-recognized therapeutic agent used to relieve involuntary movements, dystonia-related functional impairments, spasticity, and autonomic disorders such as hyperhidrosis. Musculoskeletal pain in patients with rheumatic disorders is among the emerging indications for botulinum toxin therapy. ⋯ At present, the effects of botulinum toxin and its use for pain relief remain controversial. Carefully designed prospective trials are needed to investigate the efficacy and safety of botulinum toxin in pain disorders.