Articles: back-pain.
-
Am J Phys Med Rehabil · Jul 2008
Case ReportsBack and thigh pain of unusual etiology complicates rehabilitation after bilateral total knee arthroplasty.
Total knee arthroplasty is frequently performed and usually associated with favorable results. A case is presented where persistent back and thigh pain limited rehabilitation progress following bilateral total knee arthroplasty procedures. The pain was found to be related to the presence of a symptomatic 5.24-cm infrarenal abdominal aortic aneurysm with the pain resolving after endovascular repair of the aneurysm.
-
Review Case Reports
A case of occult compartment syndrome and nonresolving rhabdomyolysis.
A 32-year-old African male presented with 10 hours of severe back pain. Initial computed tomography scan of the back showed no abnormality, and initial laboratory investigations were consistent with rhabdomyolysis. Despite stopping potential causative medications, aggressive intravenous hydration, and urine alkalinization, his creatinine kinase continued to steadily climb. Thirty-six hours after admission, a magnetic resonance imaging of his back was done because of new swelling over the right paraspinal muscles and loss of sensation in this region. Marked swelling of the right erector spinae muscles was observed, and right and left compartment pressure measurements were 108 and 21 mm Hg, respectively. He had urgent fasciotomy after which his rhabdomyolysis and pain recovered. ⋯ Our case highlights the need for early consideration of compartment syndrome as a possible cause of back pain in the setting of rhabdomyolysis. Rhabdomyolysis can present in the absence of late complications such as neurological and vascular compromise.
-
Arch Dis Child Educ Pract Ed · Jun 2008
ReviewThe investigation and management of back pain in children.
Back pain in children and adolescents is probably much less common than in adults, but its true incidence is unknown. Although back pain has traditionally been considered a rare and often sinister presentation in the paediatric age group, recent literature now suggests that a relatively high number of children do experience back pain, but only a small proportion seek medical attention. ⋯ Laboratory and imaging investigations should be targeted towards those with "red flag" symptoms and signs. Imaging studies, particularly MRI, have an important role in diagnosis of underlying pathology such as infection or malignancy.
-
Randomized Controlled Trial
Evaluating the efficacy of graded in vivo exposure for the treatment of fear in patients with chronic back pain: a randomized controlled clinical trial.
Psychological treatments for chronic pain, particularly those based upon cognitive behavioural principles, have generally been shown to be efficacious. Recently, a treatment has been developed based upon the fear-avoidance model of chronic musculoskeletal pain, which suggests chronic pain can be relieved by exposing the individual to movements and tasks that have been avoided due to fear of (re)injury. This graded in vivo exposure treatment has been found to be beneficial in case studies. ⋯ While only trend differences were observed for pain-related disability, patients in the graded in vivo exposure condition demonstrated (a) significantly greater improvements on measures of fear of pain/movement, fear avoidance beliefs, pain-related anxiety, and pain self-efficacy when compared to those in the graded activity condition, and (b) significantly greater improvements on measures of fear-avoidance beliefs, fear of pain/movement, pain-related anxiety, pain catastrophising, pain experience, and anxiety and depression when compared to those in the wait-list control condition. Additionally, patients in the graded in vivo exposure condition maintained improvements in these areas at one month follow-up. Implications of these findings for the treatment of individuals with chronic low back and other pain conditions are discussed.