Articles: back-pain.
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The rehabilitation of this client with chronic back pain was successful secondary to the efforts of her entire medical team. As demonstrated by the termination letter written by the employer when the client's medical leave exceeded 1 year, this client could not have returned to her former position without work hardening. With implementation of the Americans With Disabilities Act, changes in such employer policies might be forthcoming. ⋯ The client did not acquiesce to a therapist's goal; she actively formulated her own. Typically, a client with chronic low back pain, a history of knee problems, and an absence from work of more than 1 year has a low probability of successful rehabilitation and return to work (Isernhagen, 1988). Yet this woman was able to overcome those obstacles to return to both work and a more active life-style.(ABSTRACT TRUNCATED AT 250 WORDS)
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Sixteen experienced and 15 inexperienced observers watched videotapes showing participants of a back school program perform simple tasks to assess the functional adequacy of their posture. They had received basis or more extensive observer training. Intraclass correlation coefficients were computed as a measure of intra-and interobserver reliability. ⋯ By selecting the most reliable items two alternative measures of overall posture were constructured whose reliability coefficients ranged fromr=0.89 to 0.93 for the group of experienced observers. The reliability of the judgments by the more extensively trained inexperienced observers was also satisfactory. The observation method presented here can thus be regarded as a reliable and potentially valid instrument for assessing the outcome of back school programs.
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This study assessed the differential prevalence rates of psychopathology in chronic and acute low back pain patients. Psychopathology was assessed with the Structured Clinical Interview for the DSM-III-R (SCID). ⋯ Moreover, the chronic low back patients also had high rates of premorbid psychopathology. It was concluded that psychopathology is a major concomitant of chronic low pack pain, and that treating the psychological problems, along with the physical aspects of the chronic low back pain may increase the patient's chance of a successful therapeutic outcome.
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Comparative Study
Depression and the experience of chronic back pain: a study of related variables and age differences.
To document the prevalence of depression and examine the relationship between depression and selected pain-related variables associated with chronic back pain among elderly and nonelderly samples. ⋯ There is a high prevalence of dysphoria in both the elderly and nonelderly with chronic back pain. The relationships between pain-related constructs and depressed mood in chronic back pain patients are similar in the elderly and nonelderly. The impact of the pain experience on the individual's activities, functioning, and feelings of life control should be considered in theoretical and clinical explanations of the association between pain and depression.
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Randomized Controlled Trial Comparative Study Clinical Trial
Overexertional lumbar and thoracic back pain among recruits: a prospective study of risk factors and treatment regimens.
A total of 395 male infantry recruits were evaluated in a prospective study of possible risk factors for overexertional back pain and the efficacy of drug treatment regimens for this syndrome. Recruits were classified into subgroups of lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. ⋯ By multivariate analysis low body mass index was found to be a risk factor for overexertional lumbar pain (p = 0.005) and increased lumbar lordosis a risk factor for overexertional thoracic pain (p = 0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the end of basic training. There was no statistically significant difference between cure rates according to treatment groups.