Articles: back-pain.
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A prospective study of 17,774 patients who consulted spine centers in which the impact of spinal disorders and comorbidities on physical functional status were evaluated. ⋯ The PCS score is greatly affected in patients with spinal problems. The study population's PCS (30.4) was lower or similar to the PCS for patients with other illnesses reported in the literature: CHF (31.0), COPD (33.9), SLE (37.1), cancer (38.4), primary total hip arthroplasty (29.0), primary total knee arthroplasty (32.6), and glenohumeral degenerative joint disease (35.2). Further, the presence of comorbidity in spine patients adds to the burden of spinal conditions on functional status.
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The aim of the study is an investigation of the psychometric characteristics of the Italian translation of the Multidimensional Pain Inventory and a comparison with the American, German, Swedish and Dutch versions of the MPI. ⋯ After making appropriate changes in all 3 sections of the inventory, the MPI is substantially suitable for use in cross-cultural and international research.
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A retrospective descriptive casenote review of consecutive back pain claimants assessing claim outcome at 12 months from onset. ⋯ New Zealand's unique accident compensation environment may discourage return to work for people with back pain. New Zealand legislators should assess the impact of the ACC scheme on people with back pain, particularly in light of the recent recommendations of the International Association for the Study of Pain Task Force on Back Pain in the Workplace, that compensation cover for workers with back pain be limited to 6 weeks.
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Meta Analysis
Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain.
The objectives of the study were (1) to carry out a systematic review to assess the analgesic efficacy and the adverse effects of acupuncture compared with placebo for back and neck pain and (2) to develop a new tool, the Oxford Pain Validity Scale (OPVS), to measure validity of findings from randomized controlled trials (RCTs), and to enable ranking of trial findings according to validity within qualitative reviews. Published RCTs (of acupuncture at both traditional and non-traditional points) were identified from systematic searching of bibliographic databases (e.g. MEDLINE) and reference lists of retrieved reports. ⋯ OPVS is a useful tool for assessing the validity of trials in qualitative reviews. With acupuncture for chronic back and neck pain, we found that the most valid trials tended to be negative. There is no convincing evidence for the analgesic efficacy of acupuncture for back or neck pain.
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The literature on psychological factors in neck and back pain was systematically searched and reviewed. ⋯ Psychological factors play a significant role not only in chronic pain, but also in the etiology of acute pain, particularly in the transition to chronic problems. Specific types of psychological variables emerge and may be important in distinct developmental time frames, also implying that assessment and intervention need to reflect these variables. Still, psychological factors account for only a portion of the variance, thereby highlighting the multidimensional view. Because the methodologic quality of the studies varied considerably, future research should focus on improving quality and addressing new questions such as the mechanism, the developmental time factor, and the relevance that these risk factors have for intervention.