Articles: low-back-pain.
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Review Meta Analysis
Imaging strategies for low-back pain: systematic review and meta-analysis.
Some clinicians do lumbar imaging routinely or in the absence of historical or clinical features suggestive of serious low-back problems. We investigated the effects of routine, immediate lumbar imaging versus usual clinical care without immediate imaging on clinical outcomes in patients with low-back pain and no indication of serious underlying conditions. ⋯ Lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition.
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There is conflicting evidence regarding erector spinae muscle fatigability because previous studies have not considered the thoracic and lumbar components separately. These muscles have very different mechanical responses and, therefore, would be recruited differentially for the chosen task. ⋯ The results of this study suggested that subjects with LBP demonstrated higher fatigability of the erector spinae muscles at the thoracic part than at the lumbar part. The increased fatigability of the thoracic part needs to be emphasized in rehabilitation strategies for subjects with LBP. In addition, as age increased, the median frequency of the lumbar part of the erector spinae muscles significantly decreased. Understanding the anatomical and biomechanical characteristics of the erector spinae muscle may enhance clinical outcomes and rehabilitation strategies for subjects with LBP.
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Orthopaedic surgery · Feb 2009
Comparative StudyAnalysis of the relationship between morphology of intervertebral disc and some correlated factors following discography in patients with chronic low back pain.
To evaluate the diagnostic effectiveness of discography in discogenic low back pain (LBP). ⋯ (i) Compared with the younger patients, older LBP patients have a lower positive rate of discography despite the presence of more serious degenerative disc changes; (ii) outer layer disruption of the annulus fibrous correlates with positive discography; (iii) MRI intensity changes are not specific in diagnosing discogenic pain. Additional discography is needed to identify the painful disc; and (iv) the contrast volume injected into discs can be affected by a variety of factors which restrict its diagnostic value.
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Review of oral and poster presentations and of workshop summaries from the Ninth International Forum for Primary Care Research on Low Back Pain held in Majorca, Spain, October 4-6, 2007. ⋯ The research presented at the forum has contributed to the advancement of understanding of how to improve primary care for low back pain. The Tenth International Forum will occur on June 14-17, 2009, in Boston.
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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.