Articles: back-pain.
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The relationship between anxiety and chronic pain has been poorly studied. The authors studied the occurrence of symptoms of anxiety in chronic low back pain patients. ⋯ Anxious mood, tension and general somatic symptoms of the sensory type were more common than any other type of anxiety symptoms. The authors discuss the potential role of anxiety in chronic pain patients.
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The current study investigated the utility of the Back Pain Classification Scale with chronic, intractable low back pain and headache patients. Subjects consisted of 50 chronic low back pain and 50 chronic headache patients referred to a university based Pain Center for evaluation. Data indicated that subjects were a representative sample of severely intractable chronic pain patients typically referred for Pain Center evaluation and treatment. ⋯ It was concluded that the Back Pain Classification Scale was an empirically valid instrument to use with chronic low back pain patients, but not with chronic headache patients. This lack of utility with chronic headache patients was also viewed as support for the construct validity of the scale. Wider use of the scale with chronic low back pain patients was suggested.
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A systematic approach to low-back pain is presented that relies on the classification of patients according to their symptoms. Rational systems of physiotherapy are proposed for each group and incorporated into an algorithmn. One hundred forty-two patients with mechanical low-back pain have been treated, and their response has been assessed by means of a postal questionnaire. ⋯ Eighteen percent of patients became completely free of pain, and 59% experienced a reduction in pain level. The most effective treatment was education in back care, followed closely by an exercise program. The responses were different in the various subgroups, and a series of revised flow charts is presented.
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Stressors in the family and job environments have been proposed to play a role in the modulation of pain, yet direct empirical support for such a role is limited. The present study investigated the relationship between general stress, family and work environments (perceived social climate), psychological distress (anxiety, depression), and pain experience (sensory, affective, evaluative) in 33 ambulatory chronic low back pain (CLBP) subjects and 35 healthy controls matched for age, sex, socioeconomic status (SES), weight, and height. Results indicated that environmental stressors/social climate measures, including family conflict, family control, and general stress (Social Readjustment Rating Scale), were greater in the CLBP group. ⋯ Less peer cohesion, less physical comfort, and less job clarity were correlated with increased pain, but not distress. Work pressure was associated with decreased depression and less pain. These findings suggested the presence of both stress and operant mechanisms in the modulation of pain in the family, while operant and distraction mechanisms appear to characterize the relationship among work environment factors and pain.