Articles: back-pain.
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Compelling evidence points at both impaired proprioception and disturbed force control in patients with chronic complex regional pain syndrome (CRPS). Because force modulation at least partly relies on proprioception, we evaluated if impaired sense of force production contributes to disturbances of force control in patients with CRPS. ⋯ CRPS patients, in particular those with abnormal postures, showed impaired voluntary force control and an impaired sense of force production. This suggests that therapeutic strategies aimed at restoration of proprioceptive impairments, possibly using online visual feedback, may promote the recovery of motor function in CRPS.
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The difficulty in identifying the onset of low back pain (LBP) limits the capacity to determine the incidence of LBP at the population level and, further, to identify risk factors. In the literature, incidence cohorts have been built with patients initially considered LBP-free for 6-12 months prior to their selection. This 'clearance period' might not be sufficient to exclude recurrent patients having experienced previous LBP episodes and might result in a misclassification bias. ⋯ Screening the medical history of LBP patients can provide more accurate incidence estimates by limiting the over-ascertainment of first-time LBP patients. A 4- to 7-year clearance period should be considered.
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Low back pain is a common symptom in the older person. Whilst the majority of cases are thought to be mechanical or idiopathic and benign in nature, its multiple potential causes and concerns regarding missed diagnosis of less common but more serious underlying pathological diagnoses mean many physicians find the assessment, investigation and treatment of chronic low back pain in older adults challenging. This narrative review describes the classification of low back pain in older adults, discusses both mechanical and sinister causes of pain, highlights the appropriate use of medical imaging and provides an overview of surgical and non-surgical management of these patients.
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Low back pain (LBP), obesity, and depression are highly prevalent health conditions. We assessed the relative impact of body weight and depression on different types of LBP in a representative population sample. ⋯ BMI and depression are modifiable risk indicators for chronic disabling LBP.
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In the context of shared decision-making, a valid estimation of the probability that a given patient will improve after a specific treatment is valuable. ⋯ A registry in routine practice can be used to develop models that estimate the probability of improvement for each individual patient undergoing a specific form of treatment. Generalizing this approach to other treatments can be valuable for shared decision making.