Articles: back-pain.
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To review and summarise the prevalence of chronic back pain (CBP), chronic low back pain (CLBP) and chronic musculoskeletal pain (CMSKP) in people with spinal cord injury (SCI) and evaluate how pain is assessed. ⋯ The main finding is that the prevalence of CMSKP, and more particularly CBP and CLBP are not sufficiently reported in SCI literature. Implications for Rehabilitation There is sufficient evidence, though modest in quality and quantity, to indicate that chronic musculoskeletal pain (CMSKP), back pain (CBP) and low back pain (CLBP) are common in people with spinal cord injury (SCI). This deserves consideration by health professionals treating such patients. Pain assessment, including BP and LBP, for people with SCI should become part of the overall clinical assessment and it is preferable that standardised pain assessment tools are used. Where people with SCI suffer from CMSKP, and particularly CBP and CLBP, further consideration should be made, likely to include posture, strengthening and seating as is referral for pain medication.
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Clinical rheumatology · Jan 2014
Comparative StudyPerformance of different criteria sets for inflammatory back pain in patients with axial spondyloarthritis with and without radiographic sacroiliitis.
It is important to recognize inflammatory back pain (IBP) for an early diagnosis of ankylosing spondylitis (AS). Assessment of Spondyloarthritis International Society (ASAS) has recently published new criteria set for diagnosing IBP. In the present study, we evaluated the performance of the new ASAS IBP criteria and to compare the performance of IBP criteria sets in axial spondyloarthritis (axSpA) patients with and without radiographic sacroiliitis. ⋯ If the morning stiffness item of the Calin criteria was defined as lasting >30 min (Calin 30), the specificity improved (72.9 %), but at a price of loss in sensitivity (82.4 %). In this study, new ASAS criteria for IBP performed almost as good as but not better than the existing criteria sets. Performances of the criteria sets were quite comparable in the differentiation of IBP from MBP in patients with and without radiographic sacroiliitis.
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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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Chronic pain is one of the most prevalent health problems in the world today, yet neurological markers, critical to diagnosis of chronic pain, are still largely unknown. The ability to objectively identify individuals with chronic pain using functional magnetic resonance imaging (fMRI) data is important for the advancement of diagnosis, treatment, and theoretical knowledge of brain processes associated with chronic pain. The purpose of our research is to investigate specific neurological markers that could be used to diagnose individuals experiencing chronic pain by using multivariate pattern analysis with fMRI data. ⋯ This technique demonstrates that differences in the pattern of brain activity to induced pain can be used as a neurological marker to distinguish between individuals with and without chronic pain. Medical, legal and business professionals have recognized the importance of this research topic and of developing objective measures of chronic pain. This method of data analysis was very successful in correctly classifying each of the two groups.
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Patients who suffer from the condition known as failed back surgery syndrome (FBSS) present to the offices of physicians, surgeons, and pain specialists alike in overwhelming numbers. This condition has been defined as persistent back and/or leg pain despite having completed spinal surgery. As lumbar surgery continues to grow in prevalence, so will the number patients suffering from FBSS. ⋯ The most invasive treatment option, short of revision surgery, is spinal cord stimulation. This intervention has a number of studies demonstrating its efficacy and cost-effectiveness in this population. Finally, revision surgery may be used when indicated such as with progressive neurological impairment or with issues regarding previous surgical instrumentation.