Articles: back-pain.
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A significant number of patients who have had surgery for lumbosacral radicular syndrome still have a reduced work capacity several months later. In a prospective cohort study of 182 people who underwent lumbar disc surgery, we determined the predictive value of preoperatively measured cognitive-behavioral and work-related factors on work capacity 6 months after surgery. ⋯ Specifically, fear of movement/(re)injury, more passive pain coping, and higher physical work-load predicted reduced work capacity in multiple logistic regression analyses, taking into account the role of a wide range of control variables including demographic variables, preoperative disability and pain intensity, neurological deficits, intake of analgesics, duration of complaints, and pain intensity 3 days postoperatively. The study supports the need to develop and evaluate preoperative risk screening measures that include both cognitive-behavioral and work-related factors and to evaluate the effectiveness of cognitive-behavioral and work-related interventions in patients at risk of reduced work capacity after surgery for LRS.
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To assess the prevalence of skeletal pain in postmenopausal women before the onset of raloxifene treatment and the further course of pain during treatment in a naturalistic setting. ⋯ Raloxifene treatment in postmenopausal women with osteoporosis was associated with a marked reduction of skeletal pain and analgesic consumption and an improvement in subjective sleep quality. Further investigation in a randomised, placebo-controlled trial is warranted.
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Randomized Controlled Trial
Preventing chronic back pain: evaluation of a theory-based cognitive-behavioural training programme for patients with subacute back pain.
For long-term treatment effects, patients with subacute back pain need to adhere to treatment recommendations beyond the prescribed exercise treatment. Adherence rates are as low as 30%, so we developed a cognitive-behavioural training programme to enhance patients' self-efficacy, maximise severity perceptions and reduce barrier perceptions. ⋯ The short and simple intervention can easily be conducted by personnel, other than psychologists, i.e., physiotherapists.
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Am J Geriatr Pharmacother · Dec 2006
Multicenter StudyAssociation of age with analgesic use for back and joint disorders in outpatient settings.
Pain is a common, troubling symptom of various disorders, chronically affecting up to 11% of adults in the general public. Despite a growing emphasis on improving the quality of pain management and the increasing use of analgesics over the past 20 years, pain remains undertreated for patients in a variety of clinical settings. Elderly patients, in particular, have disproportionately low rates of adequate pain control compared with younger patients. ⋯ In outpatient settings, elderly patients with pain and back or joint disorders tend to use NSAIDs more often and opioids less often than younger patients, suggesting that older patients may be receiving a poorer quality of pain management in outpatient settings.