Articles: back-pain.
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Chronic low back pain, one of the most common reasons for seeking healthcare services, causes significant negative impacts on individuals and society. Nonpharmacologic therapies and self-management are included in practice guidelines, but their implementation is challenging. ⋯ It is feasible to learn and self-administer APA with an app, supplemented with either in-person or telehealth sessions, presenting a promising intervention toward cLBP self-management. Telehealth was found to boost this intervention effectively.
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Our study evaluates minimum clinically important difference (MCID) achievement for back pain/leg pain/disability and meeting preoperative expectations as predictors of patient satisfaction after minimally invasive lumbar decompression (MIS-LD) surgery. ⋯ Pain/disability improved after MIS-LD; improvement was strongly correlated with postoperative satisfaction. Meeting expectations/MCID achievement is associated with satisfaction. MCID achievement was equivalent to meeting expectations in predicting satisfaction at all postoperative time points for pain/disability.
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The Fear-Avoidance Model (FAM) of chronic pain posits that pain catastrophizing and fear-avoidance beliefs are prognostic for disability and chronicity. In acute low-back pain, early physical therapy (PT) is effective in reducing disability in some patients. How early PT impacts short- and long-term changes in disability for patients with acute pain is unknown. Based on the FAM, we hypothesized that early reductions in pain catastrophizing and fear-avoidance beliefs would mediate early PT's effect on changes in disability (primary outcome) and pain intensity (secondary outcome) over 3 months and 1 year. ⋯ In acute low-back pain, early PT may improve disability and pain outcomes at least partly through reducing patients' catastrophizing.