Articles: back-pain.
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Low back pain and sciatica have been treated with peridural local anesthetics for over 80 years and with epidural and subarachnoid steroid injections for a quarter of a century. This review surveyed the literature concerning the evolution, pathophysiology, complications and results of this type of therapy. The volume injected and the method used vary with different physicians and no standard has been established. ⋯ It is the authors' opinion that the rationale for the use of spinal local analgesics or steroids or intramuscular steroids has not been scientifically proven. Complications with the use of subarachnoid steroids are sufficiently serious that this form of therapy should be condemned. In this age of accountability it is imperative that therapies with questionable benefits should be critically evaluated.
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Painful glomus tumors near the coccyx have not yet been described before. Three patients with coccygodynia were treated by excision of the glomus coccygeum. ⋯ Two glomus tumors were found. The tumors of the glomus coccygeum are compared with the well-known glomus tumors "Masson".
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparing physical and behavior therapy for chronic low back pain on physical abilities, psychological distress, and patients' perceptions.
A treatment-outcome study was conducted to study the impact of behavior and physical therapy on components of the chronic low back pain syndrome. Eighteen patients received behavior therapy and 15 patients received physical therapy. All patients had at least a 6-month history of seeking treatment for chronic low back pain. ⋯ Physical therapy was based upon traditional rehabilitation theory and was designed to improve low back function. Patients were reevaluated at posttreatment, 6 months, and 1 year. The results showed a general improvement for patients in both groups and a few treatment-specific differences in outcome measures.