Articles: back-pain.
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Patients with chronic pain syndromes are commonly depressed. Chronic pain populations also contain distinct subgroups of personality profiles as defined by the MMPI. To assess the relevance of personality subtype to affective disorder we determined the relationship of psychiatric diagnoses defined by Research Diagnostic Criteria (RDC) to MMPI subgroups in a sample of hospitalized patients with predominantly chronic low back pain. ⋯ No other psychiatric diagnoses were significantly associated with distinct personality subgroups. No relationship was observed between personality profile and presence of demonstrable organic etiology for pain. These findings indicate that behavioral and pharmacological interventions directed at depression as well as pain are important in the treatment of chronic pain populations, especially in selected subgroups.
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Neurol Neurochir Pol · May 1986
Comparative Study Clinical Trial Controlled Clinical Trial[Morphine epidural block in lumbosacral pain].
In 60 patients treated in hospital for discopathy the effectiveness of morphine epidural blockade was studied in the control of very strong pain. The patients were divided into 3 groups with 20 cases in each group. Group I received morphine 5 mg with 5 ml of 1% xylocaine. ⋯ After morphine blockades the mean duration of analgesia was 20 hours, and the addition of xylocaine had no effect on it. Following xylocaine blockade the mean time of analgesia was 9.8 hours, and after normal saline injection it was 8.0 hours. The sensory phenomena experienced after morphine by most patients suggest that morphine exerts not only a local but also a central effect, while the similarity of the effects of xylocaine and normal saline suggests an analgesic effect independent of conduction block after epidural injection of these substances.
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Patients with low back pain are among the largest group of health care consumers today. During an episode of acute back pain the patient may be hospitalized for diagnostic workup and medical management, processes to which occupational therapists can contribute. The occupational therapist's evaluation includes assessment of the patient's activities of daily living and understanding of back protection and pain behaviors. ⋯ Instruction is provided in proper body mechanics, anatomy of the spine, work simplification, relaxation, and adaptive methods of performing daily activities. Given the short hospitalization period, outpatient follow-up may be provided to facilitate the application of information learned in the hospital to home and work settings. The goal of occupational therapy is to help the patient with low back pain return to a productive life-style.