Articles: back-pain.
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Clinical Trial Controlled Clinical Trial
Group outpatient physical and behavioral therapy for chronic low back pain.
Conducted a treatment-outcome study to investigate the effectiveness of behavioral (BT) or physical therapy (PT) for treating chronic low back pain (CLBP). Thirteen patients received BT; 12 patients received PT. All patients had at least a 6-month history of seeking treatment of CLBP. ⋯ BT was designed to address the environmental, social, and emotional influences of the pain experience, depression, and decreased activity from CLBP. PT was based upon traditional rehabilitation theory and was designed to improve low back function. The posttreatment results showed general improvement for patients in both groups, but few treatment-specific differences in outcome measures.
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Drawings by low back pain patients depicting the severity, type, and location of their pain have been suggested as a brief screening technique for psychological involvement in the pain complaints. A study of 212 back pain patients showed that pain drawings cannot validly be used in this way, since over half of the patients meeting MMPI criteria for psychological involvement in their pain were incorrectly identified as normal on the Pain Drawing test.
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Randomized Controlled Trial Comparative Study Clinical Trial
Transcutaneous electrical nerve stimulation for low back pain. A comparison of TENS and massage for pain and range of motion.
Patients with acute or chronic low back pain were treated in a double-blind study that compared transcutaneous electrical nerve stimulation at intense levels and gentle, mechanically administered massage. Transcutaneous electrical nerve stimulation produced significantly greater pain relief, based on two measures of the McGill Pain Questionnaire, and significant improvement in straight leg raising. ⋯ Pain-relief scores and range-of-motion scores were significantly correlated. The results indicate that pain-relief scores provide valuable information and can easily be obtained from patients for whom pain is a major symptom.
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The study investigates beliefs about control and links it to the depression found in those with chronic pain. These beliefs are interpreted within the new model of learned helplessness which distinguishes personal helplessness from universal helplessness on the basis of attributions. ⋯ Higher beliefs in chance, lack of self-blame and correlations between chance, depression and pain support the presence of universal helplessness in this group. The reporting behaviour of pain patients is discussed in the light of these findings.
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Previous research involving cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI) profiles among persons with chronic low back pain has suggested the existence of four distinct profile clusters. The present study had two goals: (1) to replicate the previous finding independently and (2) to investigate the relationship of the profiles to the subjects' self-reported pain history and response to treatment. Subjects were 92 patients in a multimodal inpatient low back-pain treatment program. ⋯ The four clusters were successfully replicated for the total sample and for males and females separately. The profiles were significantly related to subjects' pain histories, but only one outcome difference was found. It was inferred that the MMPI is of value in understanding patients' pain coping behaviors but that further research is needed to explore the utility of the MMPI in understanding their response to treatment.