Articles: back-pain.
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To assess the effects of a practice style of back pain management consistent with self-care (infrequent prescribing of pain medications and bed rest) on long-term functional outcomes, costs of care, and patient satisfaction. ⋯ A practice style consistent with back pain self-care yielded similar long-term pain and functional outcomes at lower cost and was associated with higher satisfaction with patient education compared with a practice style characterized by more frequent prescribing of pain medications and bed rest.
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Comparative Study
The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part IV: Surgical correction and back pain.
This study determined whether the prevalence, nature, and consequences of back pain in adulthood among persons who underwent Harrington rod instrumentation was related to the number of vertebrae fused, distal level of hook insertion, and degree of correction. ⋯ Among the 723 AIS subjects who had surgery at Ste. Justine's Hospital, 555 completed the questionnaire on back pain. Overall, 73% of patients treated surgically reported back pain in the past year. Proportions varied little by presurgery characteristics or by degree of surgical correction. The distal level of fusion did not influence, in any consistent way, the occurrence of back pain in later life nor the degree of disability associated with back pain. This study does not provide any evidence that extending the level of fusion down even as far as L4 will increase the prevalence of back pain in adulthood.
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Back pain after childbirth is a frequent complaint. The purpose of this study was to determine the incidence of back pain 1-2 months post partum and to identify the factors, including epidural anesthesia for labor and delivery, that may predispose to it. ⋯ The overall incidence of back pain 1-2 months post partum in this population was 44%. Predisposing factors were a history of back pain, younger age, and greater weight. Predisposing factors for new-onset post partum back pain were greater weight and shorter stature. Epidural anesthesia for labor and delivery did not appear to be associated with back pain 1-2 months post partum.
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A cohort study was undertaken using medical claims of Medicare beneficiaries. ⋯ Reoperation rates are affected not only by technical factors, but also by demographic and clinical characteristics that are often omitted from reports of surgical case series.