Articles: back-pain.
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RAND/UCLA Appropriateness Method (RUAM) applied to chiropractic manipulation for patients with chronic low-back pain (CLBP) and chronic neck pain (CNP). ⋯ Chiropractors in this US sample tend to provide manipulation to very few patients with CLBP or CNP for which it is inappropriate. However, more research is needed to determine which patients with CNP benefit from manipulation.Level of Evidence: 4.
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We evaluated the effect of the total psoas area index (TPAI = total psoas muscle area [cm2]/height squared [m2]) on neurological complications and clinical outcomes after lateral lumbar interbody fusion and identified the appropriate TPAI to achieve a substantial clinical benefit (SCB). ⋯ The TPAI had little effect on the incidence of perioperative neurological complications. However, the TPAI was identified as one of the predictors for achieving an SCB regarding back pain.
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Lumbar Spine MRI Use for Low Back Pain (OP-8) is calculated by dividing the number of patients who received lumbar magnetic resonance imaging (MRI-L) before receiving alternative treatments (e.g., physical therapy) by the total number of patients receiving MRI-L in the outpatient setting at a given institution. Since the passage of the Post-Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), OP-8 scores became tied to hospital finances. This study aims to determine how MACRA has impacted OP-8 scores since its implementation. We also aim to investigate how regional designation, profit status (for-profit, government, and nonprofit), and hospital setting (critical access, non-critical access) affect OP-8 scores. ⋯ The implementation of MACRA seems to have been unsuccessful in altering practice patterns, given the minimal change in OP-8 scores over the last 4 years. Furthermore, institutional factors are clearly correlated with a lack of adherence to magnetic resonance imaging guidelines. Given these findings, there is a need to modify health policies.
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Clin. Orthop. Relat. Res. · Sep 2021
How Common Are Chronic Residual Limb Pain, Phantom Pain, and Back Pain More Than 20 Years After Lower Limb Amputation for Malignant Tumors?
After major lower limb amputation, persistent pain is common, with up to 85% of patients reporting recurring phantom or residual-limb pain. Although pain management is an important factor of quality of life in patients with lower limb amputations, there are few long-term data regarding the frequency of persistent pain and how it impacts prosthesis use. ⋯ Level IV, therapeutic study.
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Arch Phys Med Rehabil · Sep 2021
Associations of Multiple Chronic Conditions With Physical Performance and Falls Among Older Adults With Back Pain: A Longitudinal, Population-based Study.
To determine the association of chronic conditions measured at baseline with physical performance and falls over time among older adults with back pain. We examined both number and type (depression, anxiety, arthritis) of chronic conditions. ⋯ Among older adults with back pain, those with multiple chronic conditions, including co-occurrence of arthritis, depression, and anxiety, have greater risk for poor physical functioning and falls over time.