Articles: back-pain.
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JMIR research protocols · Jul 2020
Computer-Based Stratified Primary Care for Musculoskeletal Consultations Compared With Usual Care: Study Protocol for the STarT MSK Cluster Randomized Controlled Trial.
Musculoskeletal (MSK) pain is a major cause of pain and disability. We previously developed a prognostic tool (Start Back Tool) with demonstrated effectiveness in guiding primary care low back pain management by supporting decision making using matched treatments. A logical next step is to determine whether prognostic stratified care has benefits for a broader range of common MSK pain presentations. ⋯ This trial is the first attempt, as far as we know, at testing a prognostic stratified care approach for primary care patients with MSK pain. The results of this trial should be available by the summer of 2020.
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Back pain is a relatively common presenting symptom in children and adolescents. Typical causes include muscle strain or spasm, spinal deformities (e.g., Scheuermann kyphosis, adolescent idiopathic scoliosis), spondylolysis, bulging or herniated intervertebral disks, apophysitis of the iliac crest, and functional pain syndromes such as fibromyalgia. Spondyloarthropathies such as ankylosing spondylitis may present with low back pain and stiffness, which are often worse in the morning. ⋯ Treatment for patients with muscle strain include relative rest, home-based exercises, physical therapy, and limited use of nonsteroidal anti-inflammatory drugs. If findings from the history and physical examination suggest underlying pathology, radiography and laboratory studies are indicated initially; magnetic resonance imaging, computed tomography, or a bone scan may be needed for further evaluation. It is generally accepted that the following factors warrant immediate evaluation: patient age younger than five years, symptoms persisting beyond four weeks, systemic symptoms, nighttime pain, bowel incontinence/urinary retention, or other neurologic symptoms.
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Review Meta Analysis
The effectiveness of virtual reality in patients with spinal pain: A systematic review and meta-analysis.
Virtual reality (VR) technologies have been shown to be beneficial in various areas of health care; to date, there are no systematic reviews examining the effectiveness of VR technology for the treatment of spinal pain. ⋯ VR's potential for improvement in outcomes for spinal pain that demonstrated statistical and/or clinical significance (pain intensity, disability, fear of movement, GPE, patient satisfaction, general health status, and balance) highlights the need for more focused, higher-quality research on the efficacy and effectiveness of VR for treatment of patients with spinal pain.
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To translate, culturally adapt, validate, and investigate the reliability of Arabic version of Bournemouth questionnaire (BQ) for patients with low back pain. ⋯ The Arabic version of BQ is a valid, reliable, and feasible scale for assessment of low back patients. It is short, easy-to-apply, need short time to complete and comprehensive scale. So it may be considered as a preferable scale for clinical assessment of Arabic speaking patients with low back pain.
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Multicenter Study
10 kHz High-Frequency Spinal Cord Stimulation for Chronic Thoracic Pain: A Multicenter Case Series and a Guide for Optimal Anatomic Lead Placement.
Surgical options for thoracic pain are limited and carry significant risk and morbidity. Spinal cord stimulation has the potential to be used for treatment of thoracic pain, as it has been useful for treating multiple types of chronic pain. Conventional tonic stimulation is limited in the treatment of thoracic pain, as it can produce paresthesia that is difficult to localize. Conversely, high-frequency spinal cord stimulation (HF-SCS) does not activate dorsal column A Beta fibers and does not produce paresthesia, and thus may be more beneficial in treating thoracic back pain not manageable with tonic stimulation. ⋯ Thoracic pain, back pain, spinal cord stimulation, high frequency, 10 kHz.