Articles: back-pain.
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Although safety is recognized as a critical issue in functional capacity evaluations (FCEs), it has rarely been investigated. This paper reports on the findings of a study which examined safety aspects of a new approach to FCE. ⋯ Support was found for the screening procedures of the approach, particularly blood pressure measurement, and for the combined approach to monitoring of the person's performance from biomechanical, physiological and psychophysical perspectives. Issues for FCE safety in general are identified and discussed, including the importance of screening procedures to determine readiness for FCEs and the issue of load handling in FCEs, especially in relation to clients with chronic back pain.
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Pulsed radiofrequency (PRF) has been used for the treatment of radicular pain, due to a herniated intervertebral disc, but so far the data are anecdotal. This is a retrospective study on 13 consecutive patients with this type of pain, at levels L3 to S1. All patients had a diagnosis confirmed by imaging, all had neurological abnormalities, and all were scheduled for surgical intervention. ⋯ Neurological abnormalities resolved except in one patient, who had decreased sensibility in a small area in the L3 dermatome at the last follow-up. All professionally active patients went back to work after 0.49 months (0.1 to 1). It is concluded that PRF may potentially be a viable alternative for epidural steroid injections in the treatment of acute radicular pain, due to a herniated intervertebral disc, and that further studies, including a control group, should be carried out to establish the value of this method.
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Randomized Controlled Trial Comparative Study Clinical Trial
A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain.
The aim of the present study was to evaluate the long-term outcome of a behavioural medicine rehabilitation programme and the outcome of its two main components, compared to a 'treatment-as-usual' control group. The study employed a 4 x 5 repeated-measures design with four groups and five assessment periods during a 3-year follow-up. The group studied consisted of blue-collar and service/care workers on sick leave, identified in a nationwide health insurance scheme in Sweden. ⋯ Regarding sick leave, the mean difference in the per-protocol analysis between the BM programme and the control group was 201 days, thus reducing sick leave by about two-thirds of a working year. Rehabilitating women has a substantial impact on costs for production losses, whereas rehabilitating men seem to be effortless with no significant effect on either health or costs. In conclusion, a full-time behavioural medicine programme is a cost-effective method for improving health and increasing return to work in women working in blue-collar or service/care occupations and suffering from back/neck pain.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jun 2005
Back pain and decline in lower extremity physical function among community-dwelling older persons.
Little is known regarding the longitudinal effects of back pain on physical function among older persons. We sought to determine whether back pain leading to activity restriction (i.e., restricting back pain) is associated with decline in lower extremity physical function among community-dwelling older persons. ⋯ Restricting back pain is independently associated with decline in lower extremity physical function among community-dwelling older persons. Treatment of restricting back pain may help to decrease functional decline in this population.
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Bmc Musculoskel Dis · May 2005
Multicenter Study Controlled Clinical TrialA prospective cohort study of surgical treatment for back pain with degenerated discs; study protocol.
The diagnosis of discogenic back pain often leads to spinal fusion surgery and may partly explain the recent rapid increase in lumbar fusion operations in the United States. Little is known about how patients undergoing lumbar fusion compare in preoperative physical and psychological function to patients who have degenerative discs, but receive only non-surgical care. ⋯ The primary aim of this prospective cohort study is to better define the outcomes of lumbar fusion for discogenic back pain as it is practiced in the United States. We additionally aim to identify characteristics that result in better patient selection for surgery. Potential predictors include demographics, work and disability compensation status, initial symptom severity and duration, imaging results, functional status, and psychological distress.