Articles: back-pain.
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To investigate whether the presence of Modic changes type I (MC I) found on preoperative MRI scans represent a risk factor for persistent back pain 12 months after surgery amongst patients operated for lumbar disc herniation. ⋯ Patients with preoperative MC I can expect less but still significant improvement of back pain 1 year after microdiscectomy, but not if they smoke cigarettes.
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Back pain is common in athletes and a source of missed time from practice and competition. Pain generators include muscle (strain), ligament (myofascial sprain and strain), intervertebral disc (herniation and degeneration), nerve (radiculopathy), joint (facet and sacroiliac (SI) joint), and bones (pars interarticularis defect). ⋯ The use of interventional spine procedures in athletes with back pain has gained popularity as a nonoperative treatment option. Although there is lack of high-quality evidence of these procedures specifically in athletes, this article will discuss the utility of selective nerve root blocks, epidural steroid injections, intradiscal injections, pars interarticularis injection, facet joint interventions (intraarticular injection, medial branch block, and radiofrequency neurotomy), and SI joint interventions (intraarticular injection and radiofrequency neurotomy).
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Chronic back pain is a global phenomenon and a common reason why patients seek help from health professionals. Person-centered interprofessional working is acknowledged as the main strategy for chronic back pain management; however, the complexity of chronic pain can present significant challenges for teams. Although methods used by interprofessional teams to collaborate have been previously explored, how they work together to deliver person-centered chronic back pain care has received limited attention. ⋯ Data were thematically analyzed using a constant comparative method. Three categories emerged, collective efficacy, negotiated space and team maturity, which illustrated the attributes of interprofessional teams that influenced person-centered working. The findings suggest that collective efficacy matures over time within a negotiated coalesced space and re-enforces the need for teams to stick together to ensure effective person-centered care.
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Even though the prevalence of thoracic pain has been reported to be 13% of the general population and up to 22% of the population in interventional pain management settings, the role of thoracic discs as a cause of chronic thoracic and extrathoracic pain has not been well studied. The intervertebral discs, zygapophysial or facet joints, and other structures including the costovertebral and costotransverse joints have been identified as a source of thoracic pain. ⋯ Based on the available evidence for this systematic review, due to limited evidence, thoracic provocation discography is rarely recommended for the diagnosis of discogenic pain in the thoracic spine, if conservative management has failed and facet joint pain has been excluded.