Articles: back-pain.
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Epidural steroid injection (ESI) is the most commonly performed intervention in pain clinics across the United States. This article provides an evidence-based review of ESI, including data on efficacy, patient selection, comparison of types, and complications. The data strongly suggest that ESI can provide short-term relief for radicular symptoms but are less compelling for long-term effects or relief of back pain. Although it has been asserted that transforaminal ESIs are more efficacious than interlaminar injections, the evidence supporting this is limited.
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Clinical rheumatology · Feb 2012
Prevalence, co-occurrence, and predictive factors for musculoskeletal pain among shellfish gatherers.
The aims of this study are to determine prevalence and co-occurrence of musculoskeletal pain (MSP) among shellfish gatherers and its consequences for the use of medicine, health care, and sickness leave and to investigate predictive factors (sociodemographic, lifestyle, comorbidity) of MSP in five anatomical areas (neck/shoulder/higher back, lower back, elbow/wrist/hand, hip/knee, and leg/ankle/foot). Nine hundred twenty-nine shellfish gatherers (94% women) voluntarily took part in a physiotherapy workshop. A self-administered questionnaire was used to assess MSP and its consequences. ⋯ Prevalence of MSP and musculoskeletal comorbidity were high. The study shows that the presence of pain reported in one body area is highly dependent on the total number of painful areas. These findings are consistent with those of similar studies.
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Controlled Clinical Trial
[Comparison of clinical and radiological data in the treatment of patients with osteoporotic vertebral compression fractures using radiofrequency kyphoplasty or balloon kyphoplasty].
Since the 1990s, balloon kyphoplasty has been proven as an effective method of treating patients with painful vertebral compression fractures (VCF). The radiofrequency kyphoplasty is an innovative procedure available since 2009, for which an ultra-high viscosity cement is used. For the statistical comparison of the two methods of augmentation, the clinical and radiological data of 2 larger patient groups were evaluated. ⋯ The RFK has proven to be a clinically very effective procedure that does somewhat better than BKP in long-lasting pain relief. No differences could be detected regarding improvement of functioning and the mean restoration of mid- and anterior vertebral height. As far as the safety aspect is concerned the RFK offers the advantage of a statistically significant lower proportion of cement extrusion.
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Clinical symptoms in lumbar degenerative spondylolisthesis (LDS) vary from predominantly radiating pain to severe mechanical low back pain. We examined whether the outcome of surgery for LDS varied depending on the predominant baseline symptom and the treatment administered [decompression with fusion (D&F) or decompression alone (D)]. ⋯ Our study indicated that LDS patients showed better patient-based outcome with instrumented fusion and decompression than with decompression alone, regardless of baseline symptoms. This may be due to the fact that the underlying slippage as the cause of the stenosis is better addressed with fusion.
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To determine the incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection (ESI). ⋯ The incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection is low. Recognizing the imaging features of this event permits the operator to redirect the needle tip into the epidural space and/or identify the facet joint(s) as a source of the patient's presenting pain.