Articles: low-back-pain.
-
Randomized Controlled Trial
Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial.
Chronic low back pain (CLBP) in older adults may be disabling and therapeutically challenging, largely because of the inefficacy and/or morbidity associated with traditional pain treatment. We conducted a randomized controlled trial in 200 men and women > or = age 65 with CLBP to evaluate the efficacy of percutaneous electrical nerve stimulation (PENS) with and without general conditioning and aerobic exercise (GCAE), for reducing pain and improving physical function. Participants were randomized to receive (1) PENS, (2) control-PENS (brief electrical stimulation to control for treatment expectancy), (3) PENS+GCAE, or (4) control-PENS+GCAE, twice a week for 6 weeks. ⋯ There were no significant side effects. Since brief electrical stimulation (i.e., control-PENS) facilitated comparably reduced pain and improved function at 6 months as compared with PENS, the exact dose of electrical stimulation required for analgesia cannot be determined. GCAE was more effective than PENS alone in reducing fear avoidance beliefs, but not in reducing pain or in improving physical function.
-
Randomized Controlled Trial
A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain (NCT00373867).
Psychological factors consistent with fear-avoidance models are associated with the development of chronic low back pain (LBP). As a result, graded activity (GA) and graded exposure (GX) have been suggested as behavioral treatment options. This clinical trial compared the effectiveness of treatment-based classification (TBC) physical therapy alone to TBC augmented with GA or GX for patients with acute and sub-acute LBP. ⋯ GX and TBC were associated with larger reductions in fear-avoidance beliefs at 6 months only. Six-month reduction in disability was associated with reduction in pain intensity, while 6-month reduction in pain intensity was associated with reductions in fear-avoidance beliefs and pain catastrophizing. This trial suggests that supplementing TBC with GA or GX was not effective for improving important outcomes related to the development of chronic LBP.
-
J Manipulative Physiol Ther · Nov 2008
ReviewChiropractic management of low back disorders: report from a consensus process.
Although a number of guidelines addressing manipulation, an important component of chiropractic professional care, exist, none to date have incorporated a broad-based consensus of chiropractic research and clinical experts representing mainstream chiropractic practice into a practical document designed to provide standardized parameters of care. The purpose of this project was to develop such a document. ⋯ A broad-based panel of experienced chiropractors was able to reach a high level (80%) of consensus regarding specific aspects of the chiropractic approach to care for patients with low back pain, based on both the scientific evidence and their clinical experience.
-
Randomized Controlled Trial Multicenter Study
Quality of life, resource consumption and costs of spinal cord stimulation versus conventional medical management in neuropathic pain patients with failed back surgery syndrome (PROCESS trial).
Chronic back and leg pain conditions result in patients' loss of function, reduced quality of life and increased costs to the society. ⋯ The addition of SCS to CMM in patients with neuropathic leg and back pain results in higher costs to health systems but also generates important improvements in patients' EQ-5D over the same period.
-
A cross-sectional study targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective was to clarify the present incidence of low back pain (LBP) in childhood and adolescence in Japan. It has recently been recognized that LBP in childhood and adolescence is also as common a problem as that for adults and most of these studies have been conducted in Europe, however, none have so far been made in Japan. ⋯ The severity of LBP included 81.9% at level 1, 13.9% at level 2 and 4.2% at level 3. It was revealed that LBP in childhood and adolescence is also a common complaint in Japan, and these findings are similar to previous studies conducted in Europe. LBP increased as the grade level increased and it appeared that the point and lifetime prevalence in adolescence are close to the same levels as those seen in the adulthood and there was a tendency to have more severe LBP in both cases who experienced pain for more than 1 month and those with recurrent LBP.