Articles: back-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Prediction of physician visits and prescription medicine use for back pain.
The primary purpose of this study was to examine the extent to which specific patient attitudes and beliefs about medical care and self-care for back pain predict future healthcare use. An automated database allowed examination of the predictive relationships in two primary care patient samples. In general, beliefs that physicians should find a definitive cause and permanent cure for back pain predicted neither physician visits nor prescription medication fills. ⋯ Factor analyses of the item set yielded three factors, but inconclusive results; the internal consistency of the identified sub-scales was only moderate. However, findings that a subset of items predicted physician visits and prescriptions medication fills, and was sensitive to change following a self-care intervention, suggest avenues for improving measurement of self-care orientation. These findings help clarify specific patient attitudes and beliefs that are related to healthcare utilization and suggest that a subset of these beliefs can be modified through a brief educational intervention.
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Emerg. Med. Clin. North Am. · Nov 1999
ReviewEmergency department evaluation and treatment of back pain.
Patients with back pain commonly present in the emergency department for evaluation and treatment. Because it is a common syndrome with a generally benign origin, the examiner may overlook markers of serious disease. This article reviews the important historical and physical factors to consider, with an emphasis on the red flags of serious disease. This article also reviews the management of acute lumbosacral strain, sciatica, and disc herniation, cauda equina syndrome and spinal cord compression, and back pain in the patient with a history of cancer.
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Objective. Treatment of pain associated with failed back surgery syndrome was evaluated in a pilot clinical study of a new dual lead spinal cord stimulation (SCS) system. Methods. ⋯ While external hardware problems occurred, 65% of dual lead SCS patients were willing to repeat the SCS implant procedure. Conclusions. Dual lead stimulation proved beneficial for patients with low back and leg pain associated with failed back surgery syndrome.
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Spinal cord compression is a relatively common complication of a number of malignant diseases. Back pain is the presenting symptom in more than 90% of cases. Early recognition and prompt treatment, while the patient can still walk, are the most important factors in preventing permanent and debilitating neurologic dysfunction.
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The Journal of physiology · Oct 1999
Voluntary and reflex control of human back muscles during induced pain.
1. Back pain is known to change motor patterns of the trunk. The purpose of this study was to examine the motor output of the erector spinae (ES) muscles during pain in the lumbar region. ⋯ Surprisingly, deep muscle pain had no effect on the stretch reflex. A short-latency reciprocal inhibition exists between the right and left human ES. 5. It is concluded that deep back pain does not influence the stretch reflexes in the back muscles but modulates the voluntary activation of these muscles.