Articles: back-pain.
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Pediatric emergency care · Apr 2013
Review Case ReportsIdentification of unanticipated pelvic pathology on renal bedside ultrasound.
Bedside emergency ultrasound can be a useful initial test in children who present with abdominal pain. Our case describes a teenager who presented to the emergency department with back pain and right lower quadrant pain, suspicious for nephrolithiasis. The use of bedside ultrasound enabled timely diagnosis and management of an unanticipated condition.
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Promotion of self-care for persistent back pain and other long-term conditions has become a central component in health care policy in the UK, and general practitioners face increasing demands to support patients' self-care efforts. Gaining insight into patients' views may facilitate support. ⋯ Self-care for back pain is contextualized by the individual's capacity to self-care and preferences for support. Doubt over the ability of GPs to provide support for self-care may mean that those who have specific needs are reticent to seek help. The role of self-care in the management of back pain should be discussed openly at the consultation level, and GPs may be well placed to signpost patients and provide guidance on the safety of specific self-care activities.
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To determine the prevalence of neck and upper back musculoskeletal symptoms in a group of Australian midwives and explore individual characteristics and workplace exposures associated with these symptoms. ⋯ midwives who are or may become carers for adult dependents should be aware of a possible increased risk for neck symptoms. It may be prudent for midwives and those who employ/supervise them to monitor and, where possible, jointly develop strategies to mitigate psychological job demands. The potential hazard posed by work in awkward postures warrants consideration of how midwives may minimize time spent working in these postures.
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To estimate the prevalence of insomnia in patients with chronic back pain, and to correlate insomnia with severity of back pain and disability. ⋯ 47% of patients with chronic back pain had insomnia. The ODI was more reliable than the NRS for back pain to detect insomnia. Back pain should be treated early to avoid serious health problems associated with insomnia.
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Data on the effectiveness and safety of long-term opioid therapy for chronic pain are limited. Opioid adherence monitoring includes urine drug testing. Determining whether a patient's opioid prescription should be discontinued after an unexpected urine test result can be clinically complex. ⋯ The underlying causes for worrisome behaviors such as urine drug test results that are negative for the prescribed opioid should be fully investigated. Subsequent opioid prescriptions should be based on the revised risk and benefit assessment.