Articles: back-pain.
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Comparative Study
A comparison between the Minnesota Multiphasic Personality Inventory and the 'Mensana Clinic Back Pain Test' for validating the complaint of chronic back pain.
Reports on the efficacy of the Minnesota Multiphasic Personality Inventory (MMPI) for selecting patients with valid complaints of pain have been equivocal. The Mensana Clinic Back Pain Test (MPT) was able to predict, with some degree of success, patients who had a definite organic pathologic condition. However, the MMPI measures personality traits, whereas the MPT measures the impact of pain on a patient's life. ⋯ Of the 31 patients scoring 18 points or greater on the MPT, only 26% had objective physical findings that were considered moderate or severe. Only the F scale (faking badly) of the MMPI correlated with objective physical abnormalities (r = .21340, P less than .033). However, 60% of the patients with T scores of less than 70 on the F scale had objective findings, whereas 75% of patients with T scores greater than 70 had objective physical findings.(ABSTRACT TRUNCATED AT 250 WORDS)
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Chronic low back pain (CLBP) patients with pain and symptomatology incongruent with physical pathology have been found to have a poorer outcome to medical treatment and rehabilitation, and to use health care resources excessively. To examine possible psychological and behavioral bases for this pattern, this investigation contrasted 40 CLBP patients who displayed non-organic physical signs, inappropriate symptoms, and/or anatomically incongruent pain drawings with 40 'control' CLBP patients without incongruent pain criteria. Multivariate analyses revealed that the incongruent CLBP group reported greater pain intensity and depression, received higher observer ratings of pain, displayed more ambulatory/postural pain behavior, and reported more dysfunctional cognitions during pain. ⋯ Incongruent CLBP patients still displayed more maladaptive and dysfunctional cognitions. These findings indicate that incongruent CLBP patients may be conceptualized as ineffective and overwhelmed in their attempts to cope and as more physically disabled as a result of their pain. The role of cognitive factors, reasons for failure of physically based interventions, and implications for patient management are discussed.
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Zentralbl. Neurochir. · Jan 1988
Crossed transvertebral puncture to block spinal ganglion in treatment of pain.
A simple and highly efficient percutaneous method eliminating the spinal ganglion and its posterior spinal cord root in treating metameric pain is described. Monitored by X-ray the needle crosses the vertebral canal passing e.g. from the right into the left intervertebral space. The intervention itself is made by a mesocaine alcohol block. The first experience with 12 patients is favourable in postdiscotomic syndromes or lumbar and causalgic pains in lower extremities having no mechanical cause discovered by CT.
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Comparative Study
Effects of time-limited vs unlimited compensation on pain behavior and treatment outcome in low back pain patients.
A common theme in the pain literature is that worker's compensation reinforces pain behavior and adversely influences treatment outcome of chronic pain patients. This study compared 110 chronic low back pain males divided into three groups: 44 receiving no compensation, 27 receiving time-limited worker's compensation, and 39 receiving unlimited social security disability benefits. All patients participated in a multimodal treatment program (e.g. nerve blocks, transcutaneous electrical nerve stimulation, relaxation training, biofeedback). ⋯ In general, however, more worker's compensation and non-compensation patients who were initially not working had returned to work at the time of follow-up compared with the disability patients. These results suggest that time-limited compensation may not affect treatment outcome or interfere with return-to-work chances while unlimited compensation may adversely influence the probability that patients will return to work. These findings support the notion that worker's compensation patients receiving time-limited financial benefits do not necessarily represent a 'problem' subgroup of chronic pain patients.