Articles: back-pain.
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Review Meta Analysis
The efficacy of conventional radiofrequency denervation in patients with chronic low back pain originating from the facet joints: a meta-analysis of randomized controlled trials.
Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. ⋯ Conventional radiofrequency denervation resulted in significant reductions in low back pain originating from the facet joints in patients showing the best response to diagnostic block over the first 12 months when compared with sham procedures or epidural nerve blocks.
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A pooled patient-level analysis of two multicenter randomized controlled trials and one multicenter single-arm prospective trial. ⋯ 1.
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Meta Analysis
Gray Matter Abnormalities Associated with Chronic Back Pain: A Meta-analysis of Voxel-based Morphometric Studies.
Studies employing voxel-based morphometry have reported inconsistent findings on the association of gray matter (GM) abnormalities with chronic back pain (CBP). We, therefore, performed a meta-analysis of available studies to identify the most consistent GM regions associated with CBP. ⋯ The present study demonstrates a pattern of GM alterations in CBP. These data further advance our understanding of the pathophysiology of CBP.
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Randomized Controlled Trial Multicenter Study
Who Benefits Most from Individualized Physiotherapy or Advice for Low Back Disorders? A Pre-Planned Effect Modifier Analysis of a Randomized Controlled Trial.
A preplanned effect modifier analysis of the Specific Treatment of Problems of the Spine randomized controlled trial. ⋯ 2.
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Contemp Clin Trials · Nov 2017
Randomized Controlled Trial Multicenter StudyDesign, recruitment outcomes, and sample characteristics of the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial.
This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded. ⋯ Of 240 randomized patients, 87.9% were male, 84.1% were white, and age range was 21-80years. Past-year mental health diagnoses were 28.3% depression, 17% anxiety, 9.4% PTSD, 7.9% alcohol use disorder, and 2.6% drug use disorder. In conclusion, although recruitment for this trial was challenging, characteristics of enrolled participants suggest we were successful in recruiting patients similar to those prescribed opioid therapy in usual care.