Articles: low-back-pain.
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J Manipulative Physiol Ther · Feb 2009
Randomized Controlled Trial Comparative StudyEffects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission.
The purpose of this study was to examine the immediate effects of spinal manipulative therapy (SMT) on trunk proprioception in subjects with asymptomatic chronic low back pain (CLBP) and determine if those effects lasted 1 week. ⋯ Results suggest SMT had minimal immediate effect on trunk proprioception. The effects noted occurred in session 1, implicating learning as a potential source. Learning, from repetitive proprioception training, may enhance neuromuscular control in subjects with CLBP before the use of therapeutic exercise. Subjects showed smaller deficits than previously reported for TTDPM or DM, suggesting proprioception deficits may correlate with pain level.
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Randomized Controlled Trial
Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups.
The study was a randomized controlled trial. Treatment was for 8 weeks, with follow-up posttreatment and at 6-, 12-, and 36- months. ⋯ A graded exercise intervention, emphasizing stabilizing exercises, for patients with recurrent LBP still at work seems more effective in improving disability and health parameters than daily walks do. However, no such positive results emerged for improvement regarding pain over a longer term, or for fear-avoidance beliefs.
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Curr Pain Headache Rep · Feb 2009
Comment Review Comparative StudyEpidural steroid injections are useful for the treatment of low back pain and radicular symptoms: con.
Lumbar epidural steroid injections are commonly performed in the United States for treating radicular low back pain. However, the best available data suggest that the benefit afforded by these injections is quite limited; in fact, new data suggest that in geographic areas where many such injections are performed, more and not fewer spine surgeries are actually completed annually. We suggest that further high-quality studies are required and their results respected through their implementation in daily practice to better ensure that only appropriate patients are advised to undergo this procedure.
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Curr Pain Headache Rep · Feb 2009
Review Comparative StudyEpidural steroid injections are useful for the treatment of low back pain and radicular symptoms: pro.
Epidural steroid injection has been used to treat low back pain for many decades. Numerous randomized trials have examined the efficacy of this approach. This review details the findings of older systematic reviews, newer randomized controlled trials, and two recent systematic reviews that examine the effectiveness of this treatment. ⋯ Similarly, there is scant evidence that epidural steroids have any beneficial effect in those with acute low back pain without leg pain or in those with chronic low back or leg pain. However, most studies have demonstrated more rapid resolution of leg pain in those who received epidural steroid injections versus those who did not. The role of epidural steroid injections in the management of acute radicular pain due to herniated nucleus pulposus is simply to provide earlier pain relief.