Articles: back-pain.
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A patient was treated for several years with high doses of opioids for malignant pain. During a recent hospitalization, the patient's pain remained uncontrolled despite escalating doses of various opioids. ⋯ Methadone, because of its NMDA antagonist properties, offers an effective treatment for OIH. The use of methadone for analgesia is complex and should be undertaken only by practitioners who have appropriate experience.
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Although very rare, cases of cauda equina tumours migrating several levels have been known to occur. We report two cases of cauda equina schwannomas which migrated from its primary site, one caudally and the other one rostrally as confirmed by magnetic resonance imaging perioperatively. The first patient was a 27-year-old man and the second a 41-year-old man; both presented with back pain. This report aims to remind clinicians that certain tumours attached to the roots in the lumbar spinal canal may migrate.
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J. Occup. Environ. Med. · Feb 2007
Patient clusters in acute, work-related back pain based on patterns of disability risk factors.
To identify subgroups of patients with work-related back pain based on disability risk factors. ⋯ Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.
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The intervertebral disc has been implicated as an etiology of chronic spine pain based on clinical, basic science, and epidemiological research. There is currently no way to determine with absolute certainty whether or not the disc is a spinal pain generator. At our current level of understanding, discography is thought of as the best tool to evaluate disc-related pain. ⋯ Discography is a useful imaging and pain evaluation tool in identifying a subset of patients with chronic spinal pain secondary to intervertebral disc disorders.
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Objectives. Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods. Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. ⋯ Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions. This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.