Articles: low-back-pain.
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A systematic review of randomized controlled trials (RCTs). ⋯ There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain. However, it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy.
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Low back pain (LBP) is a frequent diagnosis for sickness absence. The process of sick-listing is complex, and the doctor must integrate information from several levels in the decision. ⋯ The sick-listing process for LBP is complex, and the determinants are mostly non-medical. It seems important to adopt a broad perspective of how a worker copes with pain and how these coping strategies interact with cultural, economic, and societal determinants of sickness certification.
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Introduction. The classic presentation of ankylosing spondylitis not only impairs spinal mobility but also imposes functional limitations, and fatigue is common. Methods. We report here the outcomes of spinal cord stimulation (SCS) in the case of a 47-year-old man with low back and hip/thigh pain due to ankylosing spondylitis, with failed responses to conservative therapies aimed at treating this pain. ⋯ SCS also resulted in improved socioeconomic outcomes with a return to work. Conclusions. With further research in patients with broader presentations of the disease, SCS may prove efficacious in suppressing intractable pain symptoms due to ankylosing spondylitis, thus improving quality of life measures.
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Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. ⋯ The limited studies available suggest that these increases have not been accompanied by population-level improvements in patient outcomes or disability rates. We suggest a need for a better understanding of the basic science of pain mechanisms, more rigorous and independent trials of many treatments, a stronger regulatory stance toward approval and post-marketing surveillance of new drugs and devices for chronic pain, and a chronic disease model for managing chronic back pain.
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To describe the course of chronic low back pain in an inception cohort and to identify prognostic markers at the onset of chronicity. ⋯ More than one third of patients with recent onset, non-radicular chronic low back pain recover within 12 months. The prognosis is less favourable for those who have taken previous sick leave for low back pain, have high disability levels or high pain intensity at onset of chronic low back pain, have lower education, perceive themselves as having a high risk of persistent pain, and were born outside Australia.