Articles: back-pain.
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A survey was done of 250 patients with low back pain and sciatica, treated as outpatients in a pain relief practice, with epidural steroid injections. Repeated injections improved the success rate and provided a safe, cost effective means of treatment without the necessity of hospital admission.
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Twenty-one chronic low back pain (CLBP) patients and 20 control subjects participated in 8 successive cold pressor tests (CPT). The hypotheses were that: (1) CLBP patients would demonstrate poorer acute pain tolerance and report higher acute pain, and (2) CLBP patients would become sensitized during 8 successive CPT trials, while control subjects would habituate, resulting in increasing differences in test behavior between both groups. ⋯ These findings lead one to conclude that the deviant acute pain behavior of CLBP patient may be regarded either as a consequence of CLBP or as an important risk factor in the development of CLBP. Patients with relatively high CLBP levels performed poorly on the CPT as compared with patients with relatively low CLBP levels.
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This article, say the authors, serves as a reminder that the posterior articulations of the lumbar spine are key elements in the production of low back pain and sciatica.
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The value of patient response to epidural steroid injection as a predictor of surgical outcome was studied. One hundred and eighty-seven patients with clinical signs of root compression underwent lumbar epidural steroid injection. Eighty-five of these patients had been told that an operation on the lumbar spine would be necessary. ⋯ A statistical comparison of these two groups revealed the probability of these occurrences of 0.088. There was no correlation between outcome of open surgical procedures and response to epidural steroids. Epidural steroid injection may be a valuable aid to predicting the outcome of chemonucleolysis.
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For a normative study of chronic low back pain (CLBP), 702 consecutive admissions to a large multidisciplinary CLBP treatment program were assessed at admission, discharge, and 1-month follow-up, using a variety of psychological and functional performance instruments. Both univariate and multivariate approaches to appraising success are evaluated. ⋯ Composite indices of improvement demonstrated favorable outcomes for no less than four in every ten, and as high as nine in every ten participants. Because of the large sample size, relationships both within and across measurement domains can be assessed statistically: the separate sets of outcome measures, with the exception of psychological profiles, are generally independent of each other.