Articles: low-back-pain.
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Clin. Orthop. Relat. Res. · Oct 2009
Multicenter StudyDoes concomitant low back pain affect revision total knee arthroplasty outcomes?
The number of revision total knee arthroplasties (rev-TKA) is increasing every year. These cases are technically difficult and add considerable burden on the healthcare system. Many patients have concomitant low back pain that may interfere with functional outcome. We asked whether having low back pain at baseline would influence amount and rate of improvement on standardized outcomes measures after rev-TKA. We retrospectively reviewed 308 patients from prospectively collected data in a multicenter study. A minimum 24-month followup was available for 221 patients (71.8%). Patients with low back pain at baseline had worse scores on most instruments than their counterparts at baseline, 12 months postsurgery, and 24 months postsurgery. The data suggest concomitant back pain in patients undergoing rev-TKA affects their outcomes as measured by standardized instruments. Orthopaedic surgeons should counsel their patients with back pain regarding the possibility of slower or less complete recovery. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Randomized Controlled Trial Comparative Study
Corticosteroid injection treatment to the ischiadic spine reduced pain in women with long-lasting sacral low back pain with onset during pregnancy: a randomized, double blind, controlled trial.
Randomized double blind controlled clinical trial. ⋯ The anatomic region around the sacrospinous ligament insertion on the ischial spine is suggested to be one source of long-lasting sacral low back pain with onset during pregnancy. The pain was relieved by slow-release corticosteroid injection treatment to the ischial spine.
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J Electromyogr Kinesiol · Oct 2009
Clinical TrialImmediate effects of co-contraction training on motor control of the trunk muscles in people with recurrent low back pain.
Although deficits in the activation of abdominal muscles are present in people with low back pain (LBP), this can be modified with motor training. Training of deep abdominal muscles in isolation from the other trunk muscles, as an initial phase of training, has been shown to improve the timing of activation of the trained muscles, and reduce symptoms and recurrence of LBP. The aim of this study was to determine if training of the trunk muscles in a non-isolated manner can restore motor control of these muscles in people with LBP. ⋯ There was no significant change in the times of onset of trunk muscle EMG during arm movements nor was there any change in the variability of EMG of the abdominal muscles during walking. However, the mean amplitude and SD of abdominal EMG was reduced during walking after training. The results of this study suggest that unlike isolated voluntary training, co-contraction training of the trunk muscles does not restore the motor control of the deep abdominal muscles in people with LBP after a single session of training.
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Arthritis and rheumatism · Oct 2009
Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain.
To determine the prevalence of serious pathology in patients presenting to primary care settings with acute low back pain, and to evaluate the diagnostic accuracy of recommended "red flag" screening questions. ⋯ In patients presenting to a primary care provider with back pain, previously undiagnosed serious pathology is rare. The most common serious pathology observed was vertebral fracture. Approximately half of the cases of serious pathology were identified at the initial consultation. Some red flags have very high false-positive rates, indicating that, when used in isolation, they have little diagnostic value in the primary care setting.
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J Korean Neurosurg Soc · Oct 2009
Clinical and radiological findings of discogenic low back pain confirmed by automated pressure-controlled discography.
Few studies on the clinical spectrum of automated pressure-controlled discography (APCD)-defined positive discs have been reported to date. Thus, the present study was undertaken to analyze clinical parameters critical for diagnosis of discogenic pain and to correlate imaging findings with intradiscal pressures and pain responses in patients with APCD-positive discs. ⋯ APCD-positive discs were demonstrated in patients reporting centralized low back pain with diffuse leg pain, aggravated by sitting and standing. MRI was helpful to assess the degree of nuclear degeneration, yet it could not guarantee exact localization of the painful discs. APCD was considered to be more useful than conventional discography for diagnosis of discogenic pain.