Articles: back-pain.
-
The results of conventional chronic back pain therapy are unsatisfactory. Deconditioning, psychosocial disorders and prolonged disability are common sequelae. ⋯ Patient selection by a health fund, interdisciplinary assessment and severity adapted treatment resulted in significant reduction in pain and functional improvement in disabled back pain patients.
-
Review
Imperfect placebos are common in low back pain trials: a systematic review of the literature.
The placebo is an important tool to blind patients to treatment allocation and therefore minimise some sources of bias in clinical trials. However, placebos that are improperly designed or implemented may introduce bias into trials. The purpose of this systematic review was to evaluate the adequacy of placebo interventions used in low back pain trials. ⋯ Taken together, these results demonstrate that imperfect placebos are common in low back pain trials; a result suggesting that many trials provide potentially biased estimates of treatment efficacy. This finding has implications for the interpretation of published trials and the design of future trials. Implementation of strategies to facilitate blinding and balance expectations in randomised groups need a higher priority in low back pain research.
-
The study is a prospective observational study of 48 continuous patients with symptomatic lumbar degenerative disk disease. Each patient underwent discography, MRI, and a biochemical analysis of disk lavage fluid. ⋯ There are only weak correlations between demographic, discogram, and radiographic variables. Response to discogram cannot be predicted by non-invasive means. The disk lavage method was unable to identify the presence of specific inflammatory peptides with multi-plex immunoassays and ELISA.
-
Objectives. The probability of success with spinal cord stimulation (SCS) depends largely on appropriate patient selection. Here, we have assessed the predictive value of pain etiology as it relates to pain relief with SCS as part of a prospective multicenter clinical trial. Methods. Sixty-five subjects with chronic and intractable pain tested an epidural SCS system. ⋯ No predictive value of pain etiology was observed. Conclusions. Spinal cord stimulation is an effective therapy for neuropathic pain arising from a variety of causes. Failed back surgery syndrome, complex regional pain syndrome, and pain of other etiologies responded equally well to SCS.
-
Review
A systematic review of the predictive ability of the Orebro Musculoskeletal Pain Questionnaire.
Systematic review. ⋯ The OMPQ has moderate predictive ability in identifying patients with spinal pain at risk of persisting pain and disability. This evidence supports clinical guidelines recommending its use as an assessment tool for identifying psychosocial risk factors. Further research is needed to confirm the predictive ability of individual items in different populations and settings, to enhance its usefulness.