Articles: back-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Analgesic effect and clinical tolerability of the combination of paracetamol 500 mg and caffeine 50 mg versus paracetamol 400 mg and dextropropoxyphene 30 mg in back pain].
A double-blind randomized multicentric study was performed to test the hypothesis that the analgesic effect of paracetamol-cafeine is equivalent to that of paracetamol-dextropropoxyphen in patients suffering from pain due to osteoarthritis of the spine. ⋯ The potentializing action of cafeine on paracetamol-induced pain relief enables a degree of pain relief equivalent to that of a combination using an analgesic with a peripheral action, paracetamol, and another with a central action, dextropoxyphen. The fact that the paracetamol-cafeine combination does not have a central action avoids secondary effects induced by central analgesics (drowsiness, constipation) in patients with osteoarthritis back pain.
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Regional anesthesia · Sep 1996
Comparative Study Clinical Trial Controlled Clinical TrialPostdural puncture headache and back pain after spinal anesthesia with 27-gauge Quincke and 26-gauge Atraucan needles.
The purpose of this study was to determine whether the 26-gauge Atraucan needle shows any benefit on the incidence of postdural puncture headache (PDPH) and back pain as compared with the 27-gauge Quincke needle. ⋯ Both needles are associated with very low incidences of PDPH and back pain, which are not affected by which needle is chosen.
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One hundred consecutive patients in whom radiographs of the sacroiliac joints had been requested concurrently with radiographs of the lumbar spine and/or pelvis were reviewed to ascertain the diagnostic value of the sacroiliac radiograph. In 92 patients, radiographs of the lumbar spine or pelvis provided complete visualization of the sacroiliac joints, 81 of which were judged normal, six abnormal, and five equivocal. ⋯ In no case did the sacroiliac joint radiograph result in a normal diagnosis being changed to abnormal. Where the sacroiliac joints appear normal on a lumbar spine or pelvic radiograph, there is no diagnostic benefit, and a considerable radiation penalty, from the performance of additional radiographs specific to those joints.
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Low back pain ist frequently associated with malposition of the pelvis due to an imbalance of the postural muscles. In these patients functional malposition of both the sacrum and the ileum can be observed, resulting in differences in the length of the legs. We investigated whether the return to a normal position correlated with pain relief. ⋯ Differences in the length of the legs can be successfully treated by manual therapy at C0/C1 or C2/C3 in the majority of patients with pelvic malposition. However, infiltration of the iliosacral joints is often required as additional therapy for short-term and long-term pain relief. Treatment with NSAIDs alone is only seldom effective in cases of pelvic malposition and rarely affords long-term pain relief.
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A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. ⋯ The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.