Articles: back-pain.
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Journal of anesthesia · Jun 1997
Simple pain relief score by observers (PRSO) for assessing chronic pain.
In 56 patients with severe chronic pain, pain relief was evaluated by observation of changes in activities of daily life (ADL), drug intake, and patients' mood. The degree of pain relief was scored on the basis of these evaluations by a pain clinic physician, a nurse, and a member of the patient's family. The resulting score was termed "pain relief score by observers" (PRSO). ⋯ Although a significant correlation (rS=0.755,P<0.001) was demonstrated between the mean PRSO and VAS values, there was some dissociation between the two values in patients with underlying personal problems such as compensation lawsuits or job loss. The results suggest that an objective evaluation of pain relief is possible by PRSO alone without subjective assessment, and that PRSO can be used for patients with various types of pain. Combined assessment of pain relief by the VAS and PRSO methods may be useful to detect the influence of personal background factors in patients with chronic pain.
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Scand J Work Environ Health · Jun 1997
Psychosocial job factors associated with back and neck pain in public transit operators.
This cross-sectional study examined associations between psychosocial job factors and the prevalence of nondisabling back and neck pain in professional drivers after physical work load was taken into account. ⋯ The results provide support for the role of psychosocial job characteristics in the etiology of back or neck pain in occupational settings.
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J Pain Symptom Manage · May 1997
Cost-effectiveness analysis of spinal cord stimulation in treatment of failed back surgery syndrome.
This article presents an analysis of the medical costs of spinal cord stimulation (SCS) therapy in the treatment of patients with failed back surgery syndrome (FBSS). We compared the medical costs of SCS therapy with an alternative regimen of surgeries and other interventions. Externally powered (external) and fully internalized (internal) SCS systems were considered separately. ⋯ We found that by reducing the demand for medical care by FBSS patients, SCS therapy can lower medical costs. On average, given current screening and efficacy rates, SCS therapy pays for itself within 5.5 years. For those patients for whom SCS therapy is clinically efficacious, the therapy pays for itself within 2.1 years.
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J Pain Symptom Manage · May 1997
Spinal cord stimulation: a valuable treatment for chronic failed back surgery patients.
Spinal cord stimulation (SCS) has been used in the treatment of "chronic failed back surgery syndrome" for many years. To evaluate long-term results and cost effectiveness of SCS, we interviewed 69 patients treated during a period of 13 years. Twenty-six patients stopped using SCS; there was no clear explanation for this unsatisfactory result in 10. ⋯ Eleven patients have returned to work. In our center, the application of SCS costs on average $3660 per patient per year. Although this seems expensive, it may be a cost-effective treatment if other therapies fail.
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Int J Obstet Anesth · Apr 1997
Randomized Controlled Trial Clinical TrialPatient-controlled analgesia following caesarean section: a comparison of morphine and meptazinol.
Forty-eight women were investigated in a prospective double-blind study and randomised to receive intravenous patient-controlled analgesia (PCA) with meptazinol or morphine following elective caesarean section. Women received PCA boluses of 1 mg morphine or 10 mg meptazinol with no background infusion. ⋯ There was no statistically significant difference in pain scores (P = 0.47) or the incidence of side-effects (nausea/vomiting P = 0.076, sedation P = 0.63) between the two drugs. Meptazinol is more expensive and offers no clinical advantages in this group of patients.