Articles: back-pain.
-
Chronic back pain is characterized by a combination of neuropathic and nociceptive mechanisms of pain generation. The prevalence of the neuropathic pain component is unknown. Thus, in the context of an explorative study, we aimed to determine the prevalence of signs and symptoms indicating neuropathic pain in adult patients treated by orthopaedists. We also aimed to assess the usefulness of handheld computers (PDAs) in data collection. ⋯ Screening for neuropathic pain in this setting is feasible with simple questionnaires and scales on PDAs. Neuropathic pain is a major contributor to chronic back pain and a frequent component in patients seen by orthopaedists. At least one third of all patients should undergo additional diagnostic measures to confirm the cause of neuropathic pain.
-
Randomized Controlled Trial
The effectiveness of calcitonin on chronic back pain and daily activities in postmenopausal women with osteoporosis.
The aim of this study was to investigate the effect of nasal calcitonin on chronic back pain and disability attributed to osteoporosis. The study design involved three groups of osteoporotic postmenopausal women suffering from chronic back pain. Group I consisted of 40 women with vertebral fractures, group II of 30 women with degenerative disorders and group III of 40 patients with non specific chronic back pain and without abnormality on plain X-rays. ⋯ Repeated measures ANOVA showed that there were no significant time, group or interaction effects for pain intensity and disability in any of the groups studied. Mean Oswestry and NRS scores were reduced during the follow-up period in the groups IA, IIIA, but the differences between the two time points were not statistically significant. Intranasal calcitonin has no effect on chronic back pain intensity and functional capacity of osteoporotic women regardless of the presence of fractures, degenerative disorders or chronic back pain of non-specific etiology.
-
To describe the diagnostic and therapeutic content of visits for chronic back pain to acupuncturists, chiropractors, and massage therapists. ⋯ Information on the care patients routinely receive from CAM providers will help physicians better understand these increasingly popular forms of care.
-
Collegium antropologicum · Mar 2006
Using magnetic resonance imaging to identify the lumbosacral segment in children.
Identification of the lumbosacral (L-S) segment on magnetic resonance (MR) images is important for appropriate treatment of disease in the lumbosacral (L-S) area. In the study, data obtained from plain A-P radiographs of the L-S spine and sagittal MR imaging scans (sagittal T1- and T2-weighted sequences) of the L-S spine and sacrum with the coccygeal bone, are analyzed. Twenty-six children aged 10 to 14 years were examined for back pain. ⋯ Determination of the S1 vertebra enables detection of the L5 vertebra and, in turn, of all other lumbar vertebrae. In patients in whom a T2-weighted MR studies were done S1 could be precisely determined and so could the L5 vertebra. In this process, whether the patient had a transitional vertebra or whether there was lumbarisation or sacralisation was irrelevant.
-
Clin. Orthop. Relat. Res. · Feb 2006
ReviewFailed back surgery syndrome: surgical and nonsurgical approaches.
Failed Back Surgery Syndrome is a common and challenging clinical problem. Often the anatomic pain source is unclear. Relevant outcome studies are rarely diagnosis specific, and high level research studies comparing surgical and nonsurgical approaches to Failed Back Surgery Syndrome studies have not been published to date. Surgical strategies focus on decompressing neural impingement or fusing unstable or putatively painful intervertebral discs. Nonsurgical interventions range from nerve root specific blocks for pain relief to multidisciplinary rehabilitation programs geared toward improving function. This paper reviews the most common interventions and concludes with recommendations for the care of the individual patient. ⋯ Level V (expert opinion). See the Guidelines for Authors for a complete description of the levels of evidence.