Articles: low-back-pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
Analgesic efficacy and tolerability of flupirtine vs. tramadol in patients with subacute low back pain: a double-blind multicentre trial*.
To assess the efficacy and tolerability of flupirtine in comparison with tramadol for the treatment of moderate to severe subacute low back pain (LBP). ⋯ Flupirtine 100 mg three times daily was associated with a reduction in pain and improvements in functional capacity equivalent to that observed with tramadol 50 mg three times daily, and was better tolerated, when administered to patients with subacute back pain for one week. The limitations of this study were the lack of a placebo control and the short (7-day) duration of the study.
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Randomized Controlled Trial
Analgesic efficacy and safety of oxycodone in combination with naloxone as prolonged release tablets in patients with moderate to severe chronic pain.
This randomized, double-blind, placebo- and active-controlled, parallel-group study was designed to demonstrate the superiority of oxycodone in combination with naloxone in a prolonged release (PR) formulation over placebo with respect to analgesic efficacy. The active control group was included for sensitivity and safety analyses, and furthermore to compare the analgesic efficacy and bowel function of oxycodone PR/naloxone PR with oxycodone PR alone. The analgesic efficacy was measured as the time from the initial dose of study medication to multiple pain events (ie, inadequate analgesia) in patients with moderate to severe chronic low back pain. The full analysis population consisted of 463 patients. The times to recurrent pain events were significantly longer in the oxycodone PR/naloxone PR group compared with placebo (P < .0001-.0003); oxycodone PR/naloxone PR reduced the risk of pain events by 42% (P < .0001; full analysis population). The appearance of pain events was comparable for oxycodone PR/naloxone PR versus oxycodone PR, confirming that the addition of naloxone PR to oxycodone PR in a combination tablet did not negatively affect analgesic efficacy of the opioid. Furthermore, oxycodone PR/naloxone PR offers benefits in terms of an improvement in bowel function. In a therapeutic area of great unmet need, therefore, the combination tablet of oxycodone PR/naloxone PR offers patients effective analgesia while improving opioid-induced bowel dysfunction. Taken together with the observation that the safety profile of oxycodone PR/naloxone PR is consistent with that expected from other opioid analgesics except opioid-induced constipation, these findings indicate that the addition of naloxone to oxycodone in a PR combination tablet offers improved tolerability. Oxycodone PR/naloxone PR is therefore a promising new treatment approach for the management of chronic pain. ⋯ This study evaluated the analgesic efficacy and safety of the combination of oxycodone PR/naloxone PR in chronic nonmalignant pain. Opioids are often reduced in dosage or even discontinued as a result of impaired bowel function, leading to insufficient pain treatment. Not only does oxycodone PR/naloxone PR demonstrate analgesic efficacy comparable with oxycodone PR, but it also improves opioid-induced bowel dysfunction, and may therefore improve the acceptability of long-term opioid treatment for chronic pain.
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Eur J Phys Rehabil Med · Dec 2008
Randomized Controlled Trial Comparative StudyRandomized trial comparing the effects of one set vs two sets of resistance exercises for outpatients with chronic low back pain and leg pain.
Progressive resistance exercises (PRE) are prescribed to reverse the deconditioning associated with chronic back pain. The spine rehabilitation program has utilized 2 sets of progressive resistance exercises during each session, with increased resistance between sets, and with successive sessions. Exercise literature has challenged the need for multiple sets of resistance exercises, with a single set producing similar functional benefits. The authors studied whether completing 1 versus 2 sets of resistance exercises would affect strength, pain and disability outcomes in subjects with chronic low back pain (CLBP). ⋯ These findings suggest that there were no added benefits for completing a second set of resistance exercises during therapy sessions for patients with CLBP.
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To search literature published on the administration of intradermal sterile water injections to women in labour who experience severe low back pain, and to critically evaluate the evidence for therapeutic merit. ⋯ Intradermal injections of sterile water possess powerful analgesic benefits for women experiencing low back pain in labour and their use in this therapeutic setting is justifiable.