Articles: back-pain.
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The current study examined the prospective relationship between pain-related fear and altered motor behavior, as well as perceived interference, among 51 healthy participants following induction of delayed-onset muscle soreness (DOMS) to the trunk extensor muscles. Healthy participants without history of back pain completed standardized reaches to high and low targets at self-paced and rapid speeds before and after induction of acute low back pain using a DOMS paradigm. Pain-related fear was assessed prior to DOMS induction. ⋯ Pain-related fear scores were not predictive of lumbar flexion during baseline, but predicted reduced lumbar flexion during self- and fast-paced trials to low target locations once DOMS was induced. Pain-related fear was likewise predictive of perceived interference in life activities following DOMS induction. The findings suggest that initially pain-free individuals with high pain-related fear adopt avoidant spinal strategies during common reaching movements shortly after injury is sustained, which may comprise a risk factor for future pain and disability.
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We reviewed existing methods for identifying patients with neck and back pain in administrative data. We compared these methods using data from the Department of Veterans Affairs. ⋯ Gaps are evident in existing methods and a new framework to identify patients with neck pain and back pain in administrative data is proposed.
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Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. ⋯ These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes.
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Epidural steroid injection has been frequently performed to treat chronic pain due to lumbosacral disc herniation (L-HIVD). However, a considerable number of patients do not achieve pain relief using this method because perineural or epidural adhesions prevent the spread of injectate into the epidural space. Percutaneous adhesiolysis (PA) is thought to be a useful method because it can eliminate the deleterious effects of adhesion. ⋯ PA with NaviCath® showed clinical effectiveness in the treatment of chronic pain due to L-HIVD that was not responsive to transforaminal epidural injection. Previous surgery and the presence of spinal stenosis or spondylolisthesis were poor prognostic predictors. This procedure may enable the physician to place the catheter tip and deliver medicine more precisely.