Articles: back-pain.
-
This prospective, non-randomized clinical trial was designed to determine the clinical outcome of patients who underwent Intradiscal Electrotherapy (IDET) for the treatment of chronic discogenic low back pain. Twenty-seven consecutive patients undergoing IDET were prospectively evaluated. All patients, as determined by provocative discography and/or MRI, had discogenic disease with chronic low back pain and were non-responsive to conservative treatment for at least 6 months. ⋯ This did not translate into a significant improvement in the SF-36 survey scores. The risks are negligible, and recovery time is minimal. The procedure may be useful in selected patients who would otherwise undergo an interbody fusion procedure.
-
Fluoroscopically guided, minimum threshold electrical stimulation of the right first, second, third, and fourth lumbar medial branches and the fifth lumbar dorsal ramus in each of eight healthy test subjects was performed. The stimulation thresholds and referral patterns were recorded. A composite drawing of the referral patterns was created. The composite drawings were compared to documented referral patterns already published by other authors. ⋯ All of the subjects' mapped referral sites coincided with each other, creating a well defined composite drawing. These referral zones are different than those reported after injection of the lumbar Z-joint, which may have clinical and therapeutic implications. These referral maps may provide the clinician with additional insight when evaluating a patient with lumbar, flank, or gluteal pain of undetermined etiology.
-
Among the chronic pain problems, pain emanating from cervical and lumbar regions, independently or in combination, constitutes a significant and frequently encountered problem in interventional pain management practices. This study was designed to test the assumption that patients presenting with chronic low back pain of lumbar facet joint origin may also present with chronic neck pain of facet joint origin. ⋯ The results showed prevalence of cervical facet joint pain in 67% of the patients with a false-positive rate of 63% with a single block, whereas the prevalence of lumbar facet joint pain was seen in 40% of the patients with a 30% false-positive rate with a single block in patients presenting with chronic low back and neck pain. There was also significant correlation noted with 94% of the patients with confirmed lumbar facet joint pain also presenting with cervical facet joint pain.
-
Zygapophysial or facet joints have been implicated as cause of low back, mid back, upper back and neck pain with referred pain. Cervical, thoracic and lumbar facet joints are innervated by the medial branches of the dorsal rami. Zygapophysial (facet) joints have been implicated as the source of chronic pain in 15% to 45% of the patients with chronic low back pain, 54% to 60% of the patients with chronic neck pain and 48% of the patients with thoracic pain. ⋯ Both studies showed positive results. Similar to randomized trials, prospective, as well as retrospective evaluations showed positive evidence, both in short-term and long-term. The results of this systematic review of 2 well-designed randomized trials, 4 prospective well-designed trials without randomization and 3 retrospective evaluations provided strong evidence that radiofrequency denervation offers short-term relief and moderate evidence of long-term pain relief of facet joint origin.