Articles: back-pain.
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Z Orthop Ihre Grenzgeb · Mar 1987
[Percutaneous lumbar facet denervation. Indications and significance in chronic backache].
The lumber facet joints have been established as a source of low back pain which may radiate to the leg. Because there are no reliable clinical signs which confirm the diagnosis injections of an anaesthetic agent into the joints are necessary. Therapeutically a percutaneous radiofrequency destruction of the medial branches of lumbar dorsal rami may relieve such pain. Success rate, however, is depending on a careful selection of patients.
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The Minnesota Multiphasic Personality Inventory (MMPI) profiles of 205 male and 157 female patients with acute and chronic low back pain (LBP) were studied for replicable homogeneous subgroups using three cluster-analysis procedures. Two normal and three clinically elevated profile subgroups were identified. The two normal subgroups were characterized by relatively normal musculoskeletal condition and were least disabled, but they differed somewhat from each other in duration of pain, presence of physical abnormalities, and daily functioning. ⋯ The fifth and most pathologic profile subgroup surprisingly consisted largely of acute-pain patients whose musculoskeletal condition and daily functioning were similar to those of the normal subgroups. Patients in the three abnormal MMPI subgroups were exposed to more LBP physical-risk factors in the workplace. Implications for psychological treatment with these different profile types are discussed.
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Social science & medicine · Jan 1987
ReviewPsychological research and chronic low back pain: a stand-still or breakthrough?
Some of the main psychological research topics concerning chronic low back pain (CLBP) are critically discussed. These topics include: 1. research aimed at describing a specific low back pain personality profile, 2. research into the predictability of therapy results on the basis of psychological assessment, and 3. outcome research of psychologically-oriented treatment for CLBP. It is concluded that these topics provide little insight into the role of psychological factors in the development and maintenance of CLBP. ⋯ Discussed are: 1. Risk factors in the transition from acute to chronic LBP, 2. the deviant sensitivity to acute, experimental pain stimuli of CLBP patients, 3. the relationship between CLBP behavior and psychophysiologic variables, 4. determinants of CLBP behavior, with special attention to endurance, 5. the deviant processing of proprioceptive stimuli, and 6. the implementation for chronic pain of the unpredictability and uncontrollability paradigms. The emphasis in the presentation of these new topics is more on raising questions than on answering them.
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Acta neurochirurgica · Jan 1987
Percutaneous radiofrequency facet denervation in low-back and extremity pain.
The present series includes 47 patients (35 females 12 males) with an average observation time of 8 months after percutaneous lumbar facet denervation by radiofrequency electrocoagulation. All patients had static and kinetic lumbar pain; 90% of them had pain radiating into the legs. ⋯ Eight of the remaining 25 patients had satisfactory relief of pain at follow-up. The failures included all patients with previous multiple lumbar operations except for three.