Articles: back-pain.
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During pregnancy approximately 50% of women suffer from low back pain (LBP), which significantly affects their everyday life. The pain could result in chronic insomnia, limit the pregnant women in their ability to work and produce a reduction of their physical activity. The etiology of the pain is still critically discussed and not entirely understood. ⋯ Simulating an increased lordosis for the pregnant situation in the sagittal plane substantially reduced these acting countertorques and therefore the demand on the segmental muscles. It is assumed that hyperlordosis is a physiological adaptation to the anatomical changes during pregnancy to minimize the segmental countertorques and therefore the demand on the segmental muscles. Further, it can be expected that an enhanced muscle activity caused by selective activity of lumbar muscles increases the stability of the lumbar spine and may improve the situation with LBP during pregnancy.
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Successful treatment of chronic pain patients can be dependent on successful patient-provider communication. Patient-physician communication for patients with chronic back pain (CBP) has rarely been explored. The current study examines two questions: what is important for CBP patients concerning communication with the healthcare provider and are there interindividual differences in communication preferences dependent on sociodemographic characteristics? ⋯ By taking into account individual communication preferences of CBP patients, healthcare providers could purposefully be responsive to these, possibly contributing to a more successful treatment.
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Multicenter Study Clinical Trial
Relationship between preoperative expectations, satisfaction, and functional outcomes in patients undergoing lumbar and cervical spine surgery: a multicenter study.
Analysis of prospectively collected multicenter data. ⋯ This study showed that more than functional outcomes matter; preoperative expectations and fulfillment of expectations influence postoperative satisfaction in patients undergoing lumbar and cervical spine surgery. This underlines the importance of taking preoperative expectations into account to obtain an informed choice on the basis of the patient's preferences.
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Reg Anesth Pain Med · Jan 2012
ReviewBeyond opioid patient-controlled analgesia: a systematic review of analgesia after major spine surgery.
Postoperative pain control in patients undergoing spine surgery remains a challenge for the anesthesiologist. In addition to incisional pain, these patients experience pain arising from deeper tissues such as bones, ligaments, muscles, intervertebral disks, facet joints, and damaged nerve roots. ⋯ The problem is compounded by the fact that many of these patients are either opioid dependent or opioid tolerant, making them less responsive to the most commonly used therapy for postoperative pain (opioid-based intermittent or patient-controlled analgesia). The purpose of this review was to compare all published treatment options available that go beyond intravenous opiates and attempt to find the best possible treatment modality.