Articles: back-pain.
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Randomized Controlled Trial
The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study.
Chronic pain is prevalent in elderly populations. The goals of this study were 1) to understand the results of a randomized clinical trial - Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE) - that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2) to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. ⋯ Broader concepts of quality of life that include the concepts of self-efficacy and positive affect may be more appropriate. The results presented in this study suggest that for this population group, the approach of patient-centered outcomes is especially pertinent in order to design meaningful intervention studies in the elderly. This means that research questions, interventions, and outcome measurements need to take into account the special situation of elderly people.
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Bmc Musculoskel Dis · Jan 2014
Randomized Controlled Trial Comparative StudyAdverse events after manual therapy among patients seeking care for neck and/or back pain: a randomized controlled trial.
The safety of the manual treatment techniques such as spinal manipulation has been discussed and there is a need for more information about potential adverse events after manual therapy. The aim of this randomized controlled trial was to investigate differences in occurrence of adverse events between three different combinations of manual treatment techniques used by manual therapists (i.e. chiropractors, naprapaths, osteopaths, physicians and physiotherapists) for patients seeking care for back and/or neck pain. In addition women and men were compared regarding the occurrence of adverse events. ⋯ Adverse events after manual therapy are common and transient. Excluding spinal manipulation or stretching do not affect the occurrence of adverse events. The most common adverse event is soreness in the muscles. Women reports more adverse events than men.
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Comparative Study
Comparison of back pain prognostic risk stratification item sets.
Back pain outcomes may be improved and costs lowered through risk-stratified care, but relative performance of alternative item sets for predicting back pain outcomes has not been well characterized. We compared alternative prognostic item sets based on STarT Back and Chronic Pain Risk screeners in a cohort of patients initiating primary care for back pain. The STarT Back item set was brief and relied on binary responses, whereas the Chronic Pain Risk item set employed scaled responses and assessed pain persistence and diffuse pain. Patients (N = 571) were assessed soon after their initial visit and 502 (88%) were reassessed 4 months later. Items sets based on STarT Back and Chronic Pain Risk prognostic screeners, as well as a combination of items from both, were used to predict Chronic Pain Grade II-IV back pain at 4 months. The area under the receiver operating characteristic curve estimates (95% confidence intervals) were .79 (.74-.83) for items based on the STarT Back, .80 (.75-.83) for items based on Chronic Pain Risk, and .81 (.77-.85) for a composite item set. Differences in prediction were modest. Items from 2 prognostic screeners, and both combined, achieved acceptable and similar prediction of unfavorable back pain outcomes. ⋯ Given comparable predictive validity, choice among prognostic item sets should be based on clinical relevance, number of items, ease of administration, and item simplicity.
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Bmc Musculoskel Dis · Jan 2014
Perceptions of health professionals towards the management of back pain in the context of work: a qualitative study.
Musculoskeletal complaints have a significant impact on work in terms of reduced productivity, sickness absence and long term incapacity for work. This study sought to explore GPs' and physiotherapists' perceptions of sickness certification in patients with musculoskeletal problems. ⋯ We conclude that healthcare professionals need to take account of patients' work difficulties, their own perceived ability to offer effective guidance, and consider the 'receptivity' of employment contexts to patients' work problems, in order to ensure a smooth transition back to work.
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IgG4-related disease is a fibroinflammatory condition that affects many different organs. The common pathological findings of this disease include storiform fibrosis and dense infiltration of lymphocytes rich in IgG4-positive plasma cells. We herein presents the diagnosis and treatment of a case with a newly recognized condition - IgG4-related pachymeningitis.