Articles: back-pain.
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Comparative Study Clinical Trial
Treatment of chronic pain with spinal cord stimulation versus alternative therapies: cost-effectiveness analysis.
There is limited available research measuring the cost-effectiveness of spinal cord stimulation (SCS), compared with best medical treatment/conventional pain therapy (CPT). The purpose of this study was to tabulate the actual costs (in Canadian dollars) for a consecutive series of patients treated with SCS in a constant health care delivery environment and to compare the costs with those for a control group treated in the same controlled environment. ⋯ SCS is cost-effective in the long term, despite the initial high costs of the implantable devices.
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Greater trochanteric pain syndrome (GTPS) is a regional syndrome characterized by pain and reproducible tenderness in the region of the greater trochanter, buttock or lateral thigh that may mimic the symptoms of lumbar nerve root compression. Despite these known features, the diagnosis of GTPS is often missed, and documentation of its prevalence in an orthopedic spine specialty practice is lacking. ⋯ GTPS accounts for a substantial proportion of patients referred to our center for evaluation of low back pain. Both primary care physicians and specialty surgeons may miss this diagnosis, most common in middle-aged women. Accurate recognition of this problem earlier in the evaluation of patients with low back, buttock or lateral thigh symptoms may dramatically reduce costly patient referrals and diagnostic tests and may prevent unwarranted surgery.
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Bmc Musculoskel Dis · Jun 2002
Long-term experience with implanted intrathecal drug administration systems for failed back syndrome and chronic mechanical low back pain.
Continuous intrathecal drug delivery has been shown in open studies to improve pain and quality of life in those with intractable back pain who have had spinal surgery. There is limited data on long term effects and and even less for patients with mechanical back pain without prior spinal surgery. ⋯ We conclude that spinal drug administration systems appear to be of benefit in alleviating pain in the failed back syndrome and chronic mechanical low back pain but need to be examined prospectively.
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Differences in pain-related characteristics among younger and older veterans receiving primary care.
To characterize the nature of pain complaints among younger and older veterans receiving primary care, and to determine whether characteristics of pain vary as a function of age. ⋯ Concerns about pain are common among veterans receiving primary care. Characteristics of pain, including site, frequency, and intensity, varied as a function of age. Future studies are needed to confirm these findings in other primary care populations and to determine reasons for these differences.
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J Manipulative Physiol Ther · Jun 2002
Clinical Trial Controlled Clinical TrialClinical considerations in the use of surface electromyography: three experimental studies.
The validity and applicability of erector spinae electromyogram (EMG) use in clinical practice is questionable. Differences in the amplitude of the EMG signal between populations with low back pain (LBP) and controls have been hypothesized but not sufficiently documented. ⋯ Repeatability of the EMG signal during quiet stance is acceptable; however, bilateral asymmetry may not be a definitive indicator of dysfunction.