Articles: back-pain.
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Back pain is a common disease causing tremendous costs for treatment, rehabilitation, pension payments and work-loss. The reasons of back pain vary considerably and often remain doubtful. The effectiveness of current treatment concepts has not yet been proven significantly. In accordance with the literature, in chronic pain only multimodal concepts of treatment seem to be successful as far as they take care about somatic, psycho-social, and sport physiological aspects.
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J Manipulative Physiol Ther · Jan 1998
A pilot study of the purchase of manipulation services for acute low back pain in the United Kingdom.
The purchasing arrangements for acute low back pain recommended to UK health ministers by the Clinical Standards Advisory Group (CSAG) in 1994 as a cost-neutral way of reducing back pain disability have not been tested in practice. ⋯ GPs complied with CSAG management recommendations when funding of manipulation services was made available. Implementation was associated with better outcomes generally. A fully funded study including chronic back patients is justified.
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In recent years most industrialized nations have been confronted with a dramatic increase in cases dealing with back pain which, because of the associated costs, has put a strain on health care systems. Because of the tremendous costs caused by patients with chronic illnesses, there is a common interest in identifying determinants responsible for the pain becoming chronic. According to the fear-avoidance model, chronic back pain is the cause of specific patient beliefs according to their perception and appraisal of back pain and their assumptions about the connection between pain and work activities. These fear-avoidance beliefs are assumed as the main cognitive factors of adapting to chronic invalidism. In this study a German version of a self-reporting instrument that assesses fear-avoidance beliefs (FABQ, Waddell et al. 1993) is presented. ⋯ The results suggest that primary target points for further investigation include an analysis of the patients' beliefs about their pain, with special emphasis on fear-avoidance beliefs. It is also necessary to analyze the behavioral assumptions of the fear-avoidance model in an experimental design. Furthermore, our results concerning the psychometric properties of the questionnaire should be proved in a far larger sample of back pain patients.
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Case Reports
Continuous intrathecal meperidine via an implantable infusion pump for chronic, nonmalignant pain.
To report a continuous infusion of intrathecal meperidine via an implanted infusion pump for nonmalignant, chronic pain. ⋯ Continuous intrathecal meperidine via an implantable infusion pump may be an effective alternative in the treatment of chronic pain.