Articles: back-pain.
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Social science & medicine · Jan 1987
ReviewPsychological research and chronic low back pain: a stand-still or breakthrough?
Some of the main psychological research topics concerning chronic low back pain (CLBP) are critically discussed. These topics include: 1. research aimed at describing a specific low back pain personality profile, 2. research into the predictability of therapy results on the basis of psychological assessment, and 3. outcome research of psychologically-oriented treatment for CLBP. It is concluded that these topics provide little insight into the role of psychological factors in the development and maintenance of CLBP. ⋯ Discussed are: 1. Risk factors in the transition from acute to chronic LBP, 2. the deviant sensitivity to acute, experimental pain stimuli of CLBP patients, 3. the relationship between CLBP behavior and psychophysiologic variables, 4. determinants of CLBP behavior, with special attention to endurance, 5. the deviant processing of proprioceptive stimuli, and 6. the implementation for chronic pain of the unpredictability and uncontrollability paradigms. The emphasis in the presentation of these new topics is more on raising questions than on answering them.
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Acta neurochirurgica · Jan 1987
Percutaneous radiofrequency facet denervation in low-back and extremity pain.
The present series includes 47 patients (35 females 12 males) with an average observation time of 8 months after percutaneous lumbar facet denervation by radiofrequency electrocoagulation. All patients had static and kinetic lumbar pain; 90% of them had pain radiating into the legs. ⋯ Eight of the remaining 25 patients had satisfactory relief of pain at follow-up. The failures included all patients with previous multiple lumbar operations except for three.
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Acta neurochirurgica · Jan 1987
Epidural application of cortico-steroids in low-back pain and sciatica.
Seven women and nine men, aged 27-59 years (mean 45), with lumbar pain and sciatica had epidural blocks once with 80 mg of depo-medrol and lidocaine in individual doses. All had static and kinetic lumbar pain up to 16 years and all but four also pain radiating to the lower limbs. Radiculography was "negative" in all patients, but three exhibited minor neurological abnormalities. ⋯ In the remainder complaints were unaffected by the epidural injection. These discouraging results are not compatible with other reports, and a planned double-blind randomized investigation was abandoned. For the present category of patients (long-lasting complaints, previous "disc" operations) we found the epidural steroid injection useless.