Articles: back-pain.
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Pain drawings have frequently been used for documentation of pain and a convenient diagnosis tool. Pain drawings were found to be associated with psychological states in chronic patients with low back pain. Few researchers have investigated pain drawings except in low back pain. The aim of this study was to investigate the pain, pain drawings, psychological characteristics, and pain interference in the head, neck-shoulder (NS), and low-back/lower-limb (LB-LL) regions among patients with chronic pain. ⋯ Our results suggest that the characteristics of patients with nonorganic drawings differ according to body regions.
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The aim of this review is to make specialists in a variety of disciplines familiar with basic aspects of spinal cord stimulation and the role of mathematical modeling in understanding its mechanisms of action and the solution of basic problems. ⋯ In particular the conclusions from several computer simulation studies are relevant and of interest to specialists in many disciplines.
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Observational Study
Association of early imaging for back pain with clinical outcomes in older adults.
In contrast to the recommendations for younger adults, many guidelines allow for older adults with back pain to undergo imaging without waiting 4 to 6 weeks. However, early imaging may precipitate interventions that do not improve outcomes. ⋯ Among older adults with a new primary care visit for back pain, early imaging was not associated with better 1-year outcomes. The value of early diagnostic imaging in older adults for back pain without radiculopathy is uncertain.
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Bmc Musculoskel Dis · Mar 2015
Multicenter Study Observational StudyPsychological predictors of recovery from low back pain: a prospective study.
Recovery from low back pain (LBP) is an important outcome for patients and clinicians. Psychological factors are known to impact the course of LBP but have not been extensively investigated for predicting recovery. The purposes of this study were to: 1) describe LBP recovery rates at 6 months following 4 weeks of physical therapy; 2) identify psychological factors predictive of 6 month recovery status; and 3) identify psychological factors that co-occur with 6 month recovery status. ⋯ Our findings indicated that psychological risk status, depressive symptoms, and pain intensity were predictive of 6 month recovery status. Furthermore elevated fear-avoidance, kinesiophobia, and depressive symptoms co-occurred with non-recovery at 6 months. Future studies should investigate whether stratified psychologically informed treatment options have the potential to improve recovery rates for those most at risk for non-recovery.
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Pain as a consequence of nerve root compression may not be easy to diagnose. Degenerative changes causing nerve root compression on magnetic resonance imaging (MRI) are common but not necessarily symptomatic while the distribution of pain attributable to a particular nerve root is variable. Selective dorsal root ganglion blocks (DRGBs) have been used in these situations to aid the diagnostic process, although their use remains controversial. ⋯ In patients with diagnostic doubt, a positive DRGB is a good predictor of a positive outcome after surgery to decompress that nerve root. However, the negative predictive value is poor. This result could almost certainly be improved if there was a better definition of what constitutes a positive, and more importantly a negative, DRGB result. In the meantime, DRGBs are a useful adjunct in predicting the outcome of decompressive surgery in people with pain as a consequence of potential lumbosacral nerve root compression.