Articles: back-pain.
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Case Reports
Images of the month: Lower-back pain in a young man with HLA B27 - not always spondyloarthritis!
Presence of human leucocyte antigen (HLA) B27 in a patient with lower-back pain should not be considered synonymous with axial spondyloarthritis. Other causes of back pain should be ruled-out by careful evaluation. Lumbosacral transitional vertebra is a common congenital malformation of spine which frequently leads to mechanical back pain. ⋯ Etanercept was stopped and he was started on physiotherapy protocol for transitional vertebra, with which he improved remarkably. This case highlights the need for greater awareness among clinicians about lumbosacral transitional vertebra, a finding which is frequently missed. Presence of HLA B27 can be coincidental, as in our case.
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Arch Phys Med Rehabil · May 2020
Randomized Controlled TrialRelative Effectiveness of Electroacupuncture and Biofeedback in the Treatment of Neck and Upper Back Myofascial Pain: A Randomized Clinical Trial.
To determine the differences between clinical effects of electroacupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical myofascial pain syndrome (MPS). ⋯ Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters vs biofeedback. Thus, electroacupuncture seems to be a better complementary modality for treatment of MPS in the neck and upper back area.
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Observational Study
Microdiscectomy for lumbar disc herniation - a single center observational study.
To examine outcomes and complications following first-time lumbar microdiscectomy. ⋯ Microdiscectomy for lumbar disc herniation is an effective and safe treatment.
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Few studies have used hybrid single-photon emission computed tomography (SPECT)/computed tomography (CT) scan to identify degenerative facet disease. We aimed to determine the incidence of hypermetabolic facets on SPECT/CT imaging in patients with axial neck or back pain to elucidate the value of SPECT/CT scan in identifying pain generators. ⋯ Nearly half of all patients with axial neck or back pain demonstrated ZJH on SPECT/CT imaging, supporting ZJH sites as potential pain generators and targets for treatment. Our results support the role for SPECT/CT imaging in the workup of patients with axial neck or back pain, which may reduce invasive diagnostic procedures and aid in treatment planning.