Articles: back-pain.
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Comparative Study
American and Japanese chronic low back pain patients: cross-cultural similarities and differences.
The study compared and contrasted medical, psychological, social and general behavioral functioning of American and Japanese low back pain patients and normal controls. The Sickness Impact Profile and a standardized Medical Examination Protocol for Pain instrument were used to assess all subjects. Findings showed that the American and Japanese low back pain patients had similar and significantly higher medical-physical findings than their respective controls. ⋯ Finally, despite similar medical and physical findings, the Japanese low back pain patients were significantly less impaired in psychological, social, vocational, and avocational functioning than the American low back pain patients. It was concluded that there were significant cross-cultural differences between the American and Japanese low back pain patients, primarily in the psychosocial and behavioral areas. However, given the small sample size, any conclusion should be considered with caution; replication is needed before more definite conclusions are possible.
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Randomized Controlled Trial Clinical Trial
Parturition pain treated by intracutaneous injections of sterile water.
Forty-five pregnant women in the first stage of labour presenting with lower back pain were randomized into 2 groups. One group received intracutaneous injections of sterile water in the lumbosacral region, while the other group was given corresponding subcutaneous injections of isotonic saline, regarded as a placebo treatment. ⋯ However, the requirement of pethidine (meperidine) was similar in the 2 groups. The analgesic method presented was found to be an effective treatment against lower back pain during the first stage of labour and it is speculated that the mode of action resembles acupuncture.
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Factors that contribute to postoperative lumbar back pain and the effect of an inflatable lumbar support on the incidence of postoperative backache were examined. The study consisted of two parts, a pilot study in which mathematical models for appropriate support pressures were produced and the main study to assess the role of an inflatable lumbar support. The use of a support reduced the incidence of back pain on the first postoperative day from 46 to 21 per cent (P = 0.007). ⋯ Postoperative back pain was more severe after procedures lasting more than 40 min. Early mobilization reduced the amount of back pain. In conclusion, patients benefit from the use of an inflatable lumbar support if they have previously suffered from backache or if they are to be anaesthetized for more than 40 min.
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J Bone Joint Surg Br · May 1990
Clinical relevance of discography combined with CT scanning. A study of 100 patients.
Two different classifications of discograms have been used in a prospective study of 279 injected discs in 100 patients. The five-stage classification of Adams, Dolan and Hutton (1986) showed increased degeneration in the lower lumbar discs and more degenerative changes in men than in women. Exact reproduction of the patient's pain on injection was more common in fissured or ruptured discs than in less degenerate discs, with 81% sensitivity and 64% specificity of the discogram for pain. ⋯ Discography was found to be useful in the evaluation of chronic low back pain in patients whose ordinary CT scans, myelograms and flexion-extension radiographs were normal. In spondylolysis and spondylolisthesis, discography can disclose whether fusion needs to be extended above the lytic level, and it may show if the pain in patients who have had posterolateral fusion is discogenic. Thus, discography gives information which is useful in deciding whether to operate on patients with chronic low back pain.
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Case Reports
[Percutaneous radiofrequency neurotomy of lumbar medial branch (facet rhizotomy)--a report of 6 cases].
We performed radiofrequency neurotomy of lumbar medial branch as a treatment of facet syndrome. Our six cases had no indication for surgical therapy, such as neuralgia, spinal canal stenosis without neurological deficit except for pain and deformed spines. ⋯ By facet rhizotomy, they could obtain relief of back pain for several months to a year. We conclude that facet rhizotomy is a more effective method for facet syndrome when a proper indication is present.