Articles: back-pain.
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Br J Health Psychol · Nov 2006
An electronic diary assessment of the effects of distraction and attentional focusing on pain intensity in chronic low back pain patients.
The present study examined the effects of a manipulation of attention to pain (i.e. attentional focusing vs. distraction) on pain intensity in daily life of patients with chronic low back pain. It was hypothesized that attentional focusing would lead to decreased pain intensity in high pain fearful individuals, whereas distraction from pain would be associated with decreased pain intensity in low pain fearful individuals. ⋯ A manipulation of attention to pain in daily life of patients with chronic low back pain proved difficult to accomplish. As the manipulation check was generally unsuccessful, no clear inferences about the underlying theory can be made. Future research within the field of pain treatments (e.g. in vivo exposure) might benefit greatly from electronic diary assessments studies.
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Lumbar spinal stenosis is one of the most frequent causes of spinal surgical interventions in over 60-year olds. The exact relationship between degenerative changes and the resulting symptoms is unclear since imaging shows stenotic changes in the spines of many symptom-free patients. ⋯ The success rate two years after OP is approximately 80% in over 75-year olds. Five years after surgical intervention, an improvement in the symptoms is still recognizable in 50% of these patients.
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Background. Since 1988, spinal cord stimulation (SCS) has been used at Odense University Hospital for patients with refractory angina pectoris. The aim of our prospective study was to evaluate the long-term effects of SCS on pain, activities of daily living (ADLs), quality of life (QOL), sleep hygiene, and physical functioning for patients with angina pectoris. Methods. Before and after placement of SCS for patients with intractable angina pectoris, we performed structured telephone interviews questioning for pain relief, ADLs (Nottingham Health Profile), physical functioning (Seattle Angina Questionnaire) and sleep hygiene. ⋯ About 30% of patients discontinued treatment, the most common cause being electrode displacement and malfunction of the system. Other reasons for discontinued therapy were the evolvement of invasive treatment options such as coronary artery bypass graft and PTCA and use of such options in some patients during our prolonged observation period. Conclusion. This survey shows that SCS leads to a 70-80% improvement in pain, which, in turn, leads to improvement in QOL, whereas, physical condition and sleep pattern did not improve to the same extent.
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In comparison with men, women have a healthier lifestyle, are more rarely overweight, have less stressful occupations, or are not employed outside the home. The "gender pain bias" is the fact that women nevertheless have a higher prevalence of back pain. This paper looks at the possible underlying reasons for this as yet unexplained gender difference, using Stokols' socioecological health model as a basis. ⋯ In view of the gender difference in pain prevalence, which remains stable despite a multivariate perspective, there is clearly a need for more research into the reasons underlying the gender difference. We believe that future studies should look at rarely investigated constructs such as "sex role expectancies," "anxiety," "ethnicity," and "family history" and take anatomic differences in muscle strength into account.
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Study Design. A retrospective design comparing three matched groups was used to evaluate the application of a multidimensional approach to outcomes analysis using a variety of disease-specific and generic outcome measures to assess three treatments for failed back surgery syndrome. Objective. The objective of this study was to explore the use of a multidimensional analysis of outcomes to compare and contrast the effects of three different treatments: 1) intrathecal therapy using an implantable drug administration system (DAS), 2) standard medical therapy emphasizing the use of oral opioids (OO), and 3) residential pain and rehabilitation program (RPRP) for the treatment of chronic low back pain. Summary of Background Data. The incidence of low back pain in patients with prior back surgery remains significant. ⋯ No one treatment emerged as the most effective across all of the disease-specific and generic measures. However, patients in the DAS group tended to report greater improvement. Overall, although generally "satisfied" with treatment, they were generally "satisfied" with treatment despite continuing to report significant levels of pain, disability, and impaired QoL.