Articles: back-pain.
-
Comparative Study
[Intensity of limb pain and fatigue in fibromyalgia syndrome, depressive disorders and chronic back pain. A criterion for differentiation].
A symptom-based diagnosis of fibromyalgia syndrome (FMS) without tender point examination is needed for primary care. We tested if a symptom-based diagnosis of FMS can be founded on the intensity of the symptoms musculoskeletal pain and fatigue. ⋯ High levels of the intensity of chronic widespread musculoskeletal pain and chronic fatigue may form the basis of a symptom-based diagnosis of FMS.
-
Prospective study with 12-month follow-up. ⋯ Overall, greater back pain relative to LP at baseline was associated with a significantly worse outcome after decompression. This finding seems intuitive, but has rarely been quantified in the many predictor studies conducted to date. Consideration of relative LBP and LP scores may assist in clinical decision-making and in establishing realistic patient expectations.
-
The aim of the National Health Priority Area (NHPA) initiative is to promote cooperation between government and non-government organisations to monitor, report on and develop strategies to improve health outcomes for Australians. The seven existing NHPAs (cancer control, injury prevention and control, cardiovascular health, mental health, diabetes mellitus, asthma and musculoskeletal conditions) were selected on the basis of their profound burden on the health of Australians. Up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result. ⋯ A disadvantage of making back pain an NHPA is the risk that back pain management could become further medicalised and ineffective interventions could become more accepted. Coordinated action on back pain is needed, and integrating back pain into the NHPA framework is one solution. Informed decision making through consultation with key stakeholders is a necessary first step towards ensuring that favourable outcomes are achieved.
-
In the multimodal treatment approach to chronic back pain, interventional back procedures are often reserved for those who do not improve after more conservative management. Psychological screening prior to lumbar surgery or spinal cord stimulation (SCS) has been widely recommended to help identify suitable candidates and to predict possible complications or poor outcome from treatment. However, it remains unclear which, if any, variables are most predictive of pain-related treatment outcomes. ⋯ At present, while there is insufficient empirical evidence that psychological screening before surgery or device implantation helps to improve treatment outcomes, the current literature suggests that psychological factors such as somatization, depression, anxiety, and poor coping, are important predictors of poor outcome. More research is needed to show if early identification and treatment of these factors through psychological screening will enhance treatment outcome.