Articles: back-pain.
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This study was aimed at investigating the frequencies of non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) diagnoses and their ratios in relation to symptom duration in patients referred because of chronic back pain and suspicion of axial SpA. ⋯ Non-radiographic axial SpA represents an important differential diagnosis of back pain, especially in patients with recent symptom onset.
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A prospective, observational study. ⋯ A single ESI in postmenopausal women adversely affects BMD of the hip. This is in conjunction with a rise in bone remodeling activity, as evidenced by an increase in bone-specific alkaline phosphatase and CTX. In addition, when compared with an age-matched control population, our study population exhibited a greater decline in BMD. Our findings show that epidural administration of corticosteroids has a deleterious effect on bone, which should be considered when contemplating treatment options for radiculopathy. The resulting decrease in BMD, while slight, suggests that ESIs should be used with caution in those at a risk for fracture.
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Chronic pain and depression are highly comorbid; however, the longitudinal link is only partially understood. This study examined direct and indirect effects of chronic back pain on depression using path analysis in a general population sample, focussing on cognitive mediator variables. ⋯ These results support the cognitive mediation hypothesis which assumes that psychological variables mediate the association between pain and depression. The importance of helplessness/hopelessness is of relevance for the treatment of patients with chronic back pain.
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Because of its biopsychosocial factors chronic back pain is often resistant to unimodal therapy regimes. Multimodal pain programs are a promising therapy option in the management of chronic pain as they focus on functional restoration. The aim of the study was to evaluate the prevalence of psychopathology in patients with chronic back pain. ⋯ Fisher's exact test was performed to calculate the significance in the different subgroups. The results showed that there was a high prevalence of depression, anxiety disorders and adjustment disorders in patients with chronic back pain. In this cohort the prevalence of depression and anxiety disorders was significantly higher than the estimated prevalence of the normal German population.