Articles: back-pain.
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Observational Study
Effect of Multicolumn Lead Spinal Cord Stimulation on Low Back Pain in Failed Back Surgery Patients: A Three-Year Follow-Up.
Spinal cord stimulation (SCS) remains poorly efficient at reducing back pain in failed back surgery syndrome (FBSS) patients. We aimed at determining whether a new multicolumn lead SCS technique was efficient at durably reducing their leg (LP) and back (BP) pain. ⋯ Multicolumn lead SCS in FBSS patients significantly improve BP, LP, quality of life, and medication consumption for at least 36 months. A classical placebo effect cannot account for long-term improvements of such magnitude.
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Musculoskelet Sci Pract · Oct 2017
Comparative StudyAge-related differences in the response of the L5-S1 intervertebral disc to spinal traction.
Lumbar traction is a common treatment for low back pain; however its mechanisms of action are poorly understood. It has been hypothesized that a key effect of lumbar traction is its capacity to influence fluid movement within the intervertebral disc (IVD). ⋯ 4.
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Cross-sectional survey. ⋯ 3.
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Interdisciplinary pain therapy is nowadays the state of the art for the treatment of chronic unspecific back pain. The aim of this article is to present the retrospective analysis of the data from a 1-week intensive outpatient multimodal interdisciplinary pain therapy group program for treatment of patients with chronic unspecific back pain. ⋯ Interestingly, the results showed a significant improvement of almost all evaluated parameters even after a period of 12 months (unfortunately only data for 41 patients were available). In our opinion this improvement is due to the special constellation of the presented program, which with 1 week is relatively short but very intensive with 34 h of treatment. In addition, the program is integrated into a long-term multimodal outpatient treatment, a concept in which the multimodal treatment is individually continued after the 1‑week program. On the other hand, the results especially after 12 months have to be interpreted particularly in this context.
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Despite treatment guidelines suggesting alternatives, as well as evidence of a lack of benefit and evidence of poor long-term outcomes, opioid analgesics are commonly prescribed for back pain from the emergency department (ED). Variability in opioid prescribing suggests a lack of consensus and an opportunity to standardize and improve care. We evaluated the variation in attending emergency physician (EP) opioid prescribing for patients with uncomplicated, low acuity back pain (LABP). ⋯ We found large variability in opioid prescribing practices for LABP that persisted after adjustment for patient and clinical characteristics. Our findings support the need to further standardize and improve adherence to treatment guidelines and evidence suggesting alternatives to opioids.