Articles: back-pain.
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Comparative Study
Managing low back pain--a comparison of the beliefs and behaviors of family physicians and chiropractors.
Random samples of 605 family physicians and 299 chiropractors in Washington were surveyed to determine their beliefs about back pain and how they would respond to three hypothetic patients with back pain. With 79% of the family physicians and 70% of the chiropractors responding, family physicians and chiropractors differed greatly not only in their technical approaches to back pain--such as drug therapy versus spinal manipulation--but also in their underlying beliefs and attitudes. ⋯ Family physicians were more likely than chiropractors to feel frustrated by patients with back pain, less likely to think they can help patients prevent future episodes of back pain, and less confident that their patients are satisfied with their care. Studies are needed to determine whether the different perspectives of family physicians and chiropractors are associated with differences in the costs and outcomes of care.
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The present study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) in understanding the relationship between duration of chronic pain and psychiatric difficulties. The MMPI responses of workers' compensation patients with varying levels of low back pain chronicity were compared. One hundred ninety eight patients, divided into three groups according to length of disability, underwent social history interviews and completed the MMPI. ⋯ A series of analysis of variance designs revealed that those who were disabled for two or more years evidenced significantly more depression and psychopathology than those who were disabled for less than one year. Further statistical evaluation of 200 social history variables did not reveal significant differences between the three groups on most variables. In conjunction with previous research, the results suggested a causative link between disability and psychiatric disease.
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Journal of neurosurgery · Oct 1988
Case Reports Comparative StudyQuantification of thermal asymmetry. Part 2: Application in low-back pain and sciatica.
Temperature differences between the lower extremities were measured using a computerized thermometric scanning system in order to compare the degree of thermal asymmetry in 144 patients with low-back pain. The patients displayed highly significant thermal asymmetries, with the involved limb being cooler (p less than 0.001). ⋯ In this group of patients, thermometric study provides physicians with important information for proper decision making. The test can be performed to avoid more invasive and probably less revealing diagnostic or exploratory surgical procedures.
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Randomized Controlled Trial Clinical Trial
Changes in innominate tilt after manipulation of the sacroiliac joint in patients with low back pain. An experimental study.
The purposes of this study were to 1) propose a method to detect sacroiliac joint dysfunction (SIJD), 2) test the interrater reliability of the method on a group of patients with low back pain (LBP), and 3) document changes in innominate tilt after manipulation of the sacroiliac joint. Criteria for SIJD were established by the authors. Twenty-six patients with unilateral LBP were examined independently for presence of SIJD by two examiners. ⋯ Data were analyzed using a mixed three-factor analysis of variance. The data analysis revealed that the manipulation procedure resulted not only in an altered innominate tilt of the same side but also in an equal and opposite tilt of the opposite side (F = 67.07; df = 1.18; p less than .05). The results indicate that SIJD can be identified reliably in patients with LBP and that a manipulative procedure purported to be specific to the sacroiliac joint changes innominate tilt bilaterally and in opposite directions.
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From January 1980 through December 1984, 454 patients were evaluated with facet joint injections. All had the chief complaint of low-back pain, normal neurologic examinations and no root tension signs. Three hundred and ninety completed the protocol, which included a lumbar motion pain assessment before and after facet injection. ⋯ Patients with more pain on lumbar extension and rotation as a group, however, did not get more pain relief. From this study we were not able to identify clinical facet joint syndromes or predict patients responding better to this procedure. The facet joints were not commonly the single or primary source for low-back pain in the great majority (greater than 90%) of patients studied.