Articles: back-pain.
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Arch Phys Med Rehabil · May 2004
Comparative StudySitting and standing tolerance in patients with chronic back pain: comparison between physician prediction and covert observation.
To measure covertly observed continuous sitting and standing tolerance in patients with chronic back pain and to compare observations to physician predictions. ⋯ The majority of this sample demonstrated the ability to sit continuously 60 minutes or more and to stand continuously 30 minutes or more while being covertly observed. Expert physician prediction showed poor correlation to covertly observed sitting and standing tolerances, raising doubt about the validity of using physician evaluation to establish work restrictions in patients with chronic back pain. These findings are preliminary, follow only a brief period of covert observation, and indicate the need for further research in this area.
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Review Comparative Study
[Questionnaires for patients with back pain. Diagnosis and outcome assessment].
Self-assessment questionnaires are becoming increasingly important in the evaluation and outcome-assessment of low back pain patients, both in the research environment and in everyday clinical practice. Questionnaires allow a standardised, patient-orientated examination of the symptoms and effects of the disease as well as the assessment of change following treatment. The aim of the current review was to provide a summary of the questionnaires that are currently available in the German language for the assessment of patients with low back pain; the review focuses on those that have been shown to be reliable and valid and widely-used on an international basis. ⋯ For the analysis of treatment effects, prospective assessment of the relevant characteristics is recommended - that is, assessments should be made before the treatment and again with identical questionnaires at follow-up. Especially within the context of scientific studies, instruments should be chosen that enable an international comparison of the data generated. In everyday clinical routine, a short standardised documentation of the most important dimensions is recommended.
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Health Soc Care Community · May 2004
Comparative StudyUse of osteopathic or chiropractic services among people with back pain: a UK population survey.
Questionnaires covering health and the use of complementary, alternative and conventional health services were mailed to a random sample of 14 868 adults aged 18-64 years living in four counties of England in 1997. The present study examined the use of osteopathy/chiropractic among the 15% (n = 1377) of respondents reporting back pain. Osteopaths/chiropractors were seen by 13.4% (n = 184) of respondents with back pain during the past 3 months compared with 9.8% (n = 135) who consulted physiotherapists. ⋯ Although they reported worse pain scores than people not consulting any practitioners, their mental health, physical functioning, energy and health perception were better. It is impossible to disentangle cause and effect in this cross-sectional study, but the data suggest that people who can afford to pay are more likely to choose osteopath/chiropractor treatments than physiotherapy. The possibility that osteopath/chiropractor treatment has a generalised positive effect on health, allowing people with back pain to function better than those not receiving such treatment, warrants further investigation.
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We compared the prevalence of chronic back pain (CBP) at two points 4 years apart and examined socio-demographic, health, and pain-related factors associated with its onset and persistence. ⋯ CBP is a common and lasting problem, whose persistence and onset are predicted by clinical (especially pain) and help-seeking behavior factors, rather than socio-demographic. Prevention should focus on these factors.
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An overview is given on the current classification, description and treatment of chronic pain with causally relevant psychological factors. It is based on the "practice guidelines on somatoform disorders" and on a thematically related meta-analysis. ⋯ A modified psychotherapy for (somatoform) chronic pain is outlined. Finally, this aetiologically oriented psychosomatic-psychiatric approach is compared to psychological coping models for chronic pain.