Articles: low-back-pain.
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J Back Musculoskelet Rehabil · Jan 2009
Case ReportsA complication during caudal steroid injection.
Epidural injections in the lumbar spine are provided by caudal, lumbar interlaminar or transforaminal routes. Caudal epidural steroid injections are often used for low back pain. Fluoroscopic guidance has been frequently cited as a requirement for this procedure. In this case report, we demonstrate the importance of fluoroscopic guidance during caudal epidural injection. ⋯ A careful real time fluoroscopic monitoring should be applied with the injection of opaque material to minimize the risk of vascular injection.
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Zh Nevrol Psikhiatr · Jan 2009
Comparative Study[Peculiarities of cognitive functions in patients with chronic back pain].
The authors have studied cognitive functions and influencing factors in 64 patients with chronic low back pain. All patients have been examined using neurologic, neuroorthopedic, pathopsychological and neuropsychological methods. Patients have been divided into 2 groups according to their age: group 1 (aged 30-50 years) and group 2 (aged 51-60 years). ⋯ Significant differences in neuropsychological testing, i.e. mental flexibility, delayed memory, psychomotor speed, which referred to the subtle cognitive impairment with executive function disturbances, were found in both groups of patients with chronic low back pain as compared to pain-free adults. Sensory-discriminative (pain intensity) and affective-emotional (negative emotions, in particular, anxiety) characteristics had the effect on cognitive functions in younger patients without depressive symptoms. Affective-emotional (anxiety, psychological distress) and cognitive characteristics (i.e. catastrophising) contributed to the cognitive disturbances in older patients.
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Psycho-social medicine · Jan 2009
Are fear-avoidance beliefs in low back pain patients a risk factor for low physical activity or vice versa? A cross-lagged panel analysis.
The assumption that low back pain (LBP) patients suffer from "disuse" as a consequence of high fear-avoidance beliefs is currently under debate. A secondary analysis served to investigate whether fear-avoidance beliefs are associated cross-sectionally and longitudinally with the physical activity level (PAL) in LBP patients. ⋯ Consequently, due to missing links between fear-avoidance beliefs and physical activity in a longitudinal design, the assumptions of the fear-avoidance belief model have to be questioned. These findings are in line with other investigations published recently. Most probably, "fear-avoidance belief" represents a cognitive scheme that does not limit activity per se, but only is directed to the avoidance of specific movements.
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What factors do participants in exercise programs for chronic low back pain perceive to be important for engagement and participation? ⋯ People are likely to prefer and participate in exercise programs that are designed with consideration of their preferences, circumstances, and past exercise experiences. We propose that information about patient exercise preferences should be collected systematically.
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Epidural injection of corticosteroids is one of the most commonly used interventions in managing chronic spinal pain. The transforaminal route to the lumbar epidural space for steroid injection has gained rapid and widespread acceptance for the treatment of lumbar and leg pain. However, there are few well-designed randomized, controlled studies to determine the effectiveness of epidural injections. The role and value of transforaminal lumbar epidural steroid injections is still questioned. ⋯ The indicated evidence for transforaminal lumbar epidural steroid injections is Level II-1 for short-term relief and Level II-2 for long-term improvement in the management of lumbar nerve root and low back pain.