Articles: back-pain.
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Forsch Komplementmed · Aug 2009
Controlled Clinical Trial[Pain-relieving effect of cantharidin blister on lumbar spinal stenosis].
Lumbar spinal stenosis (LSS) is a common cause of chronic lumbar pain and disability. Conventional therapy approaches include analgesics and spinal surgery. Topical cantharidin applications are used for the treatment of severe chronic lumbar pain in traditional European medicine (TEM). We tested the pain-relieving effect of lumbar cantharidin blisters in a non-randomised controlled pilot study. ⋯ In this first study on the efficacy of cantharidin blisters, a clinically relevant pain-relieving short-term effect on LSS was observed. As the trial was non-randomised and only included a limited number of patients, the results should be interpreted with caution.
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The prospective, double-blind, randomized, placebo-controlled study design is essential in the interventional spine literature to truly evaluate whether or not a procedure is effective. ⋯ The prospective, double-blind, randomized placebo-controlled trials in the interventional spine literature demonstrate efficacy from several different procedures when properly performed on appropriate patients. Other procedures have been shown to lack efficacy, while inconclusive evidence exists from multiple other interventional spine procedures. Further details are discussed in the text.
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Cross-sectional studies have suggested a relationship between respiratory disorders, incontinence, gastrointestinal symptoms, and back pain. However, longitudinal data are lacking. This study aimed to evaluate whether these disorders increase risk for the development of back pain. A total of 2943 younger, 2298 mid-age, and 2258 older women from the Australian Longitudinal Study on Women's Health who reported no back pain during the preceding 12 months were followed for 4, 2, and 3 years, respectively. Crude and adjusted associations between the development of back pain and changes in the presence of incontinence, breathing difficulty, and gastrointestinal symptoms were assessed with logistic regression. Women with preexisting incontinence (prevalence ratios [PR]: 1.26 to 1.46) and gastrointestinal symptoms (PR: 1.24 to 1.44) and women who developed breathing problems (PR: 1.63 to 2.11) were more likely to develop back pain than women without such problems. Menstrual pain and allergy were also associated with back pain development. Consistent with predictions from physiological data, this study provides novel evidence that the presence and/or development of incontinence, respiratory problems, and gastrointestinal symptoms are associated with the development of back pain. This highlights the importance of comorbidities and suggests opportunities for future preventative interventions. ⋯ This study demonstrates that women with incontinence, respiratory disorders, and gastrointestinal symptoms have increased risk for the development of back pain. Evidence of compromised control of the spine in people with incontinence and respiratory disorders and the potential for viscerosomatic hyperalgesia in people with gastrointestinal symptoms may provide physiological explanations for these findings.
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Arthritis and rheumatism · Jul 2009
Sensitivity and specificity of spinal inflammatory lesions assessed by whole-body magnetic resonance imaging in patients with ankylosing spondylitis or recent-onset inflammatory back pain.
To determine the diagnostic utility of different spinal inflammatory lesions assessed by whole-body magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) or with recent-onset inflammatory back pain (IBP) compared with healthy controls. ⋯ Diagnostic utility of STIR MRI for AS is optimal when > or =2 CIL are present. A single CIL can be found in up to 26% of healthy individuals.