Articles: low-back-pain.
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Lumbosacral transforaminal epidural steroid injections (LS-TFESIs) are an accepted procedure used in the comprehensive, conservative care for lumbar disc pathology and/or spinal stenosis induced low back pain with a radicular component. Historically, the terminology used to describe the transforaminal technique of instilling medications into the epidural space and/or exiting structures has varied. These procedures have also been referred to as either diagnostic or therapeutic selective nerve root blocks (SNRBs). Although this procedure is typically used to "selectively" treat isolated pathology, the "SNRB" terminology suggests that one can selectively diagnose or treat a specific nerve root as a pain generator by anesthetizing or blocking it. It has been recently demonstrated that L4 and L5 SNRBs are often non-"selective" by investigating the extent of epidural contrast flow patterns after injecting 1.0 mL of contrast. Our study attempts to identify the minimum injectate volume at which LS-TFESIs may still be considered "selective" with no injectate extending to either the adjacent (superior and/or inferior) levels or to the contralateral side. ⋯ Diagnostic LS-TFESI or SNRB blocks limiting injectate to a single, ipsilateral segmental level cannot reliably be considered diagnostically selective with volumes exceeding 0.5mL. Injectate volumes greater than 0.5mL are consistently non-selective and cannot be used reliably for diagnostic block procedures in the epidural space.
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Cross-sectional study. ⋯ There is a high prevalence of FJ OA in the community. Prevalence of FJ OA increases with age with the highest prevalence at the L4-L5 spinal level. At low spinal levels women have a higher prevalence of lumbar FJ OA than men. In the present study, we failed to find an association between FJ OA, identified by multidetector CT, at any spinal level and LBP in a community-based study population.
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Treatment of intractable chronic pain employs, nerve block, peripheral nerve stimulation, phototherapy, and drug therapy such as opioid and analgesia adjuvant. We also employ multi disciplinary approach with internal medicine, psychiatry and other related fields. In addition, in a portion of intractable chronic back pain, the pain relief is obtained by interventional approaches such as adhesionlysis and the neuroplasty with epiduroscopy as well as spinal cord stimulation therapy.
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Electromyogr Clin Neurophysiol · Nov 2008
Influence of trunk muscle co-contraction on spinal curvature during sitting reclining against the backrest of a chair.
Today, many office workers frequently adopt a relaxed or slumped sitting posture for many hours, and often people tend to spend their leisure time reclining against the backrest of a chair while sitting for a long time, as when watching television. While sitting, the pelvis rotates backwardly, and lumbar lordosis is flattened. Simultaneously, the load on the intervertebral discs and spine increases. ⋯ The co-contraction of the trunk muscles resulted in significantly less lumbar curvature and more sacral angle than during slump sitting. The thoracic curvature showed no significant change during either sitting posture. The results of this study indicated that co-contraction of the trunk muscles during sitting reclining against the backrest of a chair could bring about the correct lumbar curvature, effectively stabilize the lumbopelvic region, and decrease focal stress on passive structures.
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The aim of this study was to determine whether body mass index (BMI) influences the risk of low back pain (LBP) in a population exposed to whole body vibration (WBV). For this a self-administered questionnaire was sent to 467 participants, driving occupational vehicles. Vibration measurements were performed according to ISO 2631-1 on a representative sample (n=30) of this population. ⋯ No significant increased risk was found for the onset of LBP with the increase of BMI, neither for the last 7 days (OR 1.02; 95% CI: 0.93-1.23) nor for the past 12 months LBP (OR 0.98; 95% CI: 0.89-1.09). Introducing the interaction with WBV exposure in the logistic regression model, did not result a significant increased risk in the onset of LBP-7 days (OR 0.97; 95% CI: 0.92-1.01) nor in the onset of LBP 12 months (OR 0.97; 95% CI: 0.93-1.01) either. Occupational participants exposed to WBV, with a high BMI do not have an increased risk for the development of LBP.