Articles: back-pain.
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Comparative Study
The association between clinical findings on physical examination and self-reported severity in back pain. Results of a population-based study.
A cross-sectional population-based study of back pain. ⋯ Assessment of severity in back pain can only partly be based on the clinical findings of a physical examination. There is a relatively weak agreement between the results of physical examination and the subjective reporting of pain and disability.
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In only 30% of back pain patients an underlying pathology can be found. Rheumatologic causes in a narrow sense are fibromyalgia, osteoporosis and the group of spondylathropathies and reactive arthritis. Infectious disorders of the spine are emergency cases and need immediate and interdisciplinary action. ⋯ In acute, nonspecific back pain, the aim is to prevent a chronification of disease by instruction and education of the patient and an early start of physical therapy. The rehabilitation process in chronic cases in complex and may need psychobehavioral methods for pain control. Pharmacologic modalities of treatment-simple analgesics, nonsteroidal antirheumatic drugs, muscle relaxants and antidepressants-should only be used for a limited period and monitored constantly.
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Randomized Controlled Trial Clinical Trial
Multidisciplinary rehabilitation for chronic back pain in an outpatient setting: a controlled randomized trial.
Based on existing models for pain chronicity and effective treatment strategies for patients with chronic low back pain, a multidisciplinary rehabilitation programme for an outpatient group setting was developed. The main treatment components address the patient's physical functional capacity (functional restoring), cognitive and affective processes (pain management strategies), and behavioural and ergonomical aspects (back school elements). Short-term (immediately after intervention) and long-term effects (at 6-months follow-up) of the intervention were assessed in a randomized controlled study. ⋯ In contrast to post-treatment results, there were also significant improvements in strength and endurance. Overall results testify to the effectiveness of the intervention programme. Future studies (with larger sample sizes) should aim at a further improvement of functional capacity and disability perception, an analysis of differential treatment effects, and strategies for an improved long-term maintenance of the changes induced by the programme.
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We report a case of a hernia through the thoracolumbar fascia in a young adult male who presented with pain and swelling in the thoracolumbar region. Surgical repair of the defect was performed in the superficial layer of the thoracolumbar fascia and, 18 months following surgery, he remained asymptomatic. The purpose of this report is to make clinicians aware of a thoracolumbar hernia as a rare cause of back pain.