Articles: back-pain.
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Randomized Controlled Trial
Economic evaluation of an implementation strategy for the management of low back pain in general practice.
In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. ⋯ Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.
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British journal of pain · May 2017
Schoolbags and back pain in children between 8 and 13 years: a national study.
Schoolbag weight in schoolchildren is a recurrent and contentious issue within the educational and health sphere. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. There is limited research regarding this among the Maltese paediatric population. ⋯ The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group.
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Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting. ⋯ This cost utility analysis of lumbar interlaminar epidural injections in patients nonresponsive to conservative management in the treatment of disc herniation, central spinal stenosis, and axial or discogenic low back pain in the lumbar spine shows the clinical effectiveness and cost utility of these injections of $1,976.58 for direct costs with a total cost of $3,301 per QALY.
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Reports of Baastrup disease have been underrepresented in the medical literature. Therefore, the current comprehensive review was performed by searching standard search engines using the terms "Baastrup's," "disease," "lumbar," "interspinous bursitis," and "kissing spine disease." Baastrup disease appears to be more common than once believed. Baastrup disease is associated with other degenerative disease processes of the spine that could potentially lead a physician to perform unnecessary surgery. Appreciation of this disease and identification on imaging can improve diagnosis and appropriate treatment of associated back pain.
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Observational Study
Trends in diagnosis of painful neck and back conditions, 2002 to 2011.
Neck and back pain are pervasive problems. Some have suggested that rising incidence may be associated with the evidence of rising prevalence. To describe the trends in diagnosis of painful neck and back conditions in a large national healthcare system. ⋯ In a national population, the prevalence rate for diagnosis of neck and back pain grew 1.8 to 2.3 times faster than the incidence rate. This suggests that the average duration of episodes of care is increasing. Additional research is needed to understand the influences on the differential rate of change and to develop efficient and effective care systems.