Articles: back-pain.
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J Bone Joint Surg Am · Jan 1985
Randomized Controlled Trial Clinical TrialThe use of epidural steroids in the treatment of lumbar radicular pain. A prospective, randomized, double-blind study.
Seventy-three patients with lumbar radicular pain syndromes were treated in a prospective, randomized, double-blind fashion with either seven milliliters of methylprednisolone acetate and procaine or seven milliliters of physiological saline solution and procaine. All patients had radiographic confirmation of lumbar nerve-root compression, consistent with the clinical diagnosis of either an acute herniated nucleus pulposus or spinal stenosis. ⋯ Long-term follow-up, averaging twenty months, failed to demonstrate the efficacy of a second injection of epidural steroids administered to the patients whose pain did not respond within twenty-four hours to an injection of either eighty milligrams of methylprednisolone acetate combined with five milliliters of 1 per cent procaine or two milliliters of sterile saline combined with five milliliters of 1 per cent procaine. Therefore, a decision to use epidural steroids must be made with the realization that we failed to demonstrate its clinical efficacy in this study and that reports of serious complications of this procedure have been published.
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Addictive behaviors · Jan 1985
Narcotic utilization for back pain patients housed in private and semi-private rooms.
Hospital records from 40 back pain patients in private rooms and 40 back pain patients in semi-private rooms were reviewed to determine: (a) if patients in private rooms used more narcotics than patients in semi-private rooms; and (b) whether room type was a predictive variable for narcotic utilization. Patients in private rooms were found to be more likely to use intramuscular request-contingent narcotics than similar patients in semi-private rooms. No differences in the amount of narcotics were observed for other categories of narcotic analgesics. Room type, relevant medical, and demographic variables failed to account for this difference in medication utilization, suggesting that other factors such as medical staff and patient personality variables may be playing an important role in contributing to the use of narcotic analgesics by back-pain patients.
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Med. Clin. North Am. · Nov 1984
ReviewThe low back pain syndrome. Diagnostic impact of high-resolution computed tomography.
This article focuses on low back pain which is directly related to the spinal axis and its supporting structures (spondylogenic back pain). This type of back pain is particularly prominent in our society, is frequently managed surgically, and has benefited from most advanced diagnostic imaging with computed tomography.
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This study compared 47 patients with chronic low back pain who were involved in personal injury litigation with 33 patients not seeking compensation who were also complaining of low back pain. Pain was assessed using a visual analogue scale and the adjectival check-list of the McGill Pain Questionnaire. Psychological state was assessed using the Zung Depression Scale, the State-Trait Anxiety Inventory, the Eysenck Personality Inventory and the Hostility and Direction of Hostility Questionnaire. ⋯ There was no difference between the two groups on ratings of pain severity or pain description, and no difference on measures of psychological disturbance. Both groups had significant elevations of mean depression, neuroticism, state anxiety and trait anxiety scores when compared with the normal population. It was concluded that there is no support for the claim that personal injury litigants describe their pain as more severe than do non-litigants, and that both groups show similar levels of psychological disturbance.