Articles: low-back-pain.
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J Orthop Surg (Hong Kong) · Aug 2009
Correlation of low back pain to a high-intensity zone of the lumbar disc in Indian patients.
To assess the correlation between low back pain and a high-intensity zone (HIZ) of the lumbar disc in Indian patients. ⋯ The presence of an HIZ is not diagnostic of a disrupted and painful disc, and should be interpreted together with other prevailing symptoms and clinical findings.
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In vivo measurements of low back flexion posture and muscle activity before, during, and after static flexion. ⋯ Fatigue of low back extensor muscles may occur in static flexion due to prolonged passive stretching of the muscles. Low back extensor muscles are required to generate more active forces in weight holding or lifting after static flexion to compensate for the reduced contribution of creep deformed passive tissues in maintaining spinal stability and the posture. The degraded force generating capacity of the fatigued muscles can be a significant risk factor for low back pain.
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We conducted a methodologic study. ⋯ We conclude that the 11-item Internal Validity Checklist is associated with effect size in randomized trials of interventions for back pain, and that our data support the use of a sum score of the number of fulfilled items in this list.
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Systematic Review. ⋯ Massage might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions, to assess the impact of massage on return-to-work, and to determine cost-effectiveness of massage as an intervention for low back pain.
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A new technique for performing nerve blocks of the ganglion impar (ganglion Walther) is presented. These injections have been reported to relieve coccydynia (tailbone pain), as well as other malignant and nonmalignant pelvic pain syndromes. A variety of techniques have been previously described for blocking this sympathetic nerve ganglion, which is located in the retrorectal space just anterior to the upper coccygeal segments. ⋯ This article presents a new, paracoccygeal approach whereby the needle is inserted alongside the coccyx and the needle is guided through three discrete steps with a rotating or corkscrew trajectory. Compared with some of the previously published techniques, this paracoccygeal corkscrew approach has multiple potential benefits, including ease of fluoroscopic guidance using the lateral view, ability to easily use a stylet for the spinal needle, and use of a shorter, thinner needle. While no single technique works best for all patients and each technique has potential advantages and disadvantages, this new technique adds to the available options.