Articles: back-pain.
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Spinal cord stimulation has been extensively utilized in the treatment of conditions including complex regional pain syndrome, ischemic limb pain, failed back surgery syndrome, and angina pectoris. Recognized complications include infection, dural tap, and electrode movement. We report the case of a patient who experienced a sensation of extremely enhanced stimulation in the area covered by the spinal cord stimulator while in the vicinity of a high-tension electricity substation. Full resolution of symptoms occurred when the spinal cord stimulator was switched off, indicating that active stimulators may be susceptible to the effects of external electrical fields.
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Limb movement imparts a perturbation to the body. The impact of that perturbation is limited via anticipatory postural adjustments. The strategy by which the CNS controls anticipatory postural adjustments of the trunk muscles during limb movement is altered during acute back pain and in people with recurrent back pain, even when they are pain free. ⋯ In both instances, the changes were consistent with adoption of an altered strategy for postural control and were similar to those observed in patients with recurrent back pain. We conclude that anticipation of experimental back pain evokes a protective postural strategy that stiffens the spine. This protective strategy is associated with compressive cost and is thought to predispose to spinal injury if maintained long term.
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Revue médicale de Liège · Oct 2004
[Indications for epidural steroids in back pain and in radiculopathy].
Back pain is very frequent in western countries and it represents a very high social cost. The treatment is based on five modalities: medication, physiotherapy, invasive technics, rehabilitation programs and psycho-social approaches. Several treatments may be proposed simultaneously and introduced gradually. ⋯ The initial treatment of back pain is medical. This pathology is multifactorial and the relief of symptoms is often incomplete. The patient should be urged to feel responsible for and involved in his treatment.
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Multicenter Study
Back pain, disability, and radiographic vertebral fracture in European women: a prospective study.
Vertebral fractures are associated with back pain and disability. There are, however, few prospective data looking at back pain and disability following identification of radiographic vertebral fracture. The aim of this analysis was to determine the impact of radiographically identified vertebral fracture on the subsequent occurrence of back pain and disability. ⋯ After adjustment for age, center, and frequency of back pain at baseline, compared with those without baseline vertebral fracture, those with a prevalent fracture were no more likely to report back pain at follow-up (OR = 1.2; 95% CI, 0.8 to 1.7). There was a small increased risk among those with a preexisting fracture who had sustained an incident fracture during follow-up (OR = 1.6; 95% CI, 0.6 to 4.1) though the confidence intervals embraced unity. In conclusion, although there was no significant increase in the level of back pain an average of 5 years following identification of radiographic vertebral fracture, women who suffered a further fracture during follow-up experienced substantial levels of disability with impairment in key physical functions of independent living.
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Opioids are used not only in the treatment of cancer pain, but also pain of non-malignant genesis. In recent years, the efficacy of controlled release (CR) oxycodone in the treatment of the above-mentioned types of pain has been investigated in a number of clinical studies. The present article reviews the clinical studies that have been already published. ⋯ Since there are no clinical relevant metabolites, there is no danger of accumulation in patients with renal infarction due to these metabolites. Side effects are those typical for opioids, and are readily manageable. CR oxycodone is a good alternative in the treatment of non-cancer pain and can be recommended as first-line treatment for the above-mentioned indications.