Articles: back-pain.
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Lumbar radiculalgia may be due, beside the disc-nerve root conflict, to stenosis of osteoarticular canals, wide dural sac, epidural lipomatosis, segmental arachnoiditis, malignant or benign tumours and meningoradiculitis. Extraspinal truncular or radicular sciatica is usually due to compression by an expansive process. Some types of pain referred from articular structures may mimic sciatica.
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The interexaminer reliability of an inclinometer procedure to measure lumbar rotation was evaluated by two chiropractic clinicians who examined 25 chronic (greater than 6 months) low-back pain patients and 25 subjects without low-back pain. These groups were compared for differences in mean left, right, and total rotation. Patients who had lumbar spinal surgery were excluded. ⋯ Also, there was significantly more total rotation in the asymptomatic subjects (F = 4.143; df = 1; P less than 0.048). However, because of the large error attributed to this procedure, it is not possible to say whether the difference between the two groups is a result of the large error or some "real" difference. Therefore, the procedure described in this study should not be used as a clinical outcome measure.
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Comparative Study
Comparison of cognitive-behavioral group treatment and an alternative non-psychological treatment for chronic low back pain.
This study was designed to investigate the relative efficacy of cognitive-behavioral group treatment, including relaxation training, in comparison with a control condition in a sample of 20 outpatients with chronic low back pain. Subjects in both conditions also received the same physiotherapy back-education and exercise program. ⋯ The combined psychological treatment and physiotherapy condition displayed significantly greater improvement than the attention-control and physiotherapy condition at post-treatment on measures of other-rated functional impairment, use of active coping strategies, self-efficacy beliefs, and medication use. These differences were maintained at 6 month follow-up on use of active coping strategies and, to a lesser degree, on self-efficacy beliefs and other-rated functional impairment.
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This study compared the psychometric properties of two scales designed to measure attitudes towards and beliefs about pain. The Survey of Pain Attitudes (Revised) SOPA(R) (Jensen and Karoly 1987) and the Pain Beliefs and Perceptions Inventory (PBPI) (Williams and Thorn 1989) were examined in terms of internal consistency, discriminant validity, factor structure, construct validity and sensitivity to age and gender effects. ⋯ Further work is suggested for the PBPI, as the reported factor structure was not replicated. Discussion centered around the possible reasons for this finding, with issues such as the possible orientation of different treatment facilities, the possible differences in attitudes between patients with different types of pain, and the possible influence of length of years in pain or the receipt of workers compensation payments being considered.
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J Manipulative Physiol Ther · Feb 1992
Diagnostic utility of the McGill Pain Questionnaire and the Oswestry Disability Questionnaire for classification of low back pain syndromes.
Verbal pain description and assessment of functional limitations are key components in the clinical evaluation of patients with low back pain syndromes. Using the McGill Pain Questionnaire (MPQ) to quantify the pain experience and the Oswestry Disability Questionnaire (ODQ) to quantify functional disability, a study was undertaken to determine the efficiency with which the MPQ and ODQ were capable of enhancing the differential diagnosis of three broad categories of low back syndromes. Three discriminative models were employed. ⋯ The greatest utility of the discriminant models was found to be ruling out nonspecific low back pain and ruling in radiculopathy, with and without neurological deficits. Subjective pain and disability appear to have the potential for successfully differentiating broad categories of low back pain. Further studies need to be performed to assess the discriminant power of the MPQ and ODQ for specific diagnostic entities.