Articles: low-back-pain.
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Clinical biomechanics · Jul 2008
Stature loss and recovery following a period of loading: effect of time of day and presence or absence of low back pain.
Stature reductions in asymptomatic individuals, caused by a set load, are lower later in the day when stature is in the trough of diurnal variation; hence most stature reduction investigations are conducted in the morning. Recent evidence suggests that it is not the reductions in stature, but the recovery of stature, that is of greatest importance. The aim of this investigation was to establish whether stature recovery is also affected by time of day and to determine if any differences exist between a chronic low back pain and asymptomatic group. ⋯ Further investigations of stature recovery should be restricted to the morning when comparing individuals with and without chronic low back pain, as time of day appeared to have effect on stature recovery, particularly in the asymptomatic group. Time dependent differences in stature change between these two populations warrants further investigation.
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Case Reports
Low-dose intrathecal naloxone to enhance intrathecal morphine analgesia: a case report.
Ultra low doses of opioid antagonists such as naloxone block excitatory opioid receptor pathways may paradoxically enhance morphine analgesia. This case study reports safety and efficacy of ultra low-dose intrathecal (IT) naloxone added to IT morphine for the treatment of severe refractory chronic low back pain. A 56-year-old man with a history of severe chronic low back pain (post-laminectomy syndrome) was evaluated. ⋯ There were no signs of adverse drug toxicity or hemodynamic compromise. An IT infusion of daily morphine 5 mg and naloxone 50 ng was started. Throughout the 3-year follow-up period, the patient maintained pain reduction of 60 to 80 percent, with a return to daily activities and no further hospitalizations.
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Previous reports of the efficacy of percutaneous pulsed radiofrequency have been confounded by fewer case numbers, poor patient selection, and limited data on cervical or lumbar radicular pain. We used percutaneous pulsed radiofrequency for cervical and lumbar radicular pain, and the study has more than 100 cases for the analysis of the efficacy of percutaneous pulsed radiofrequency. ⋯ The results of this retrospective analysis showed that the application of pulsed radiofrequency is a safe and useful intervention for cervical and lumbar radicular pain. The satisfactory pain relief obtained by most of our patients justifies the start of this study for at least 6 months. Although pulsed radiofrequency appears to provide intermediate-term relief of pain, further studies with long-term follow-up are necessary.
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J Manipulative Physiol Ther · Jul 2008
Adverse events following chiropractic care for subjects with neck or low-back pain: do the benefits outweigh the risks?
This synopsis provides an overview of the benign and serious risks associated with chiropractic care for subjects with neck or low-back pain. Most adverse events associated with spinal manipulation are benign and self-limiting. The incidence of severe complications following chiropractic care and manipulation is extremely low. The best evidence suggests that chiropractic care is a useful therapy for subjects with neck or low-back pain for which the risks of serious adverse events should be considered negligible.
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J Manipulative Physiol Ther · Jun 2008
Comparative StudyManual therapy provided by physical therapists in a hospital-based setting: a retrospective analysis.
The purpose of this study was to compare outcomes, complications, and hospital disposition in a cohort of patients hospitalized for low back pain who receive physical therapist (PT)-administered manual therapy (mobilization and manipulation) vs those who do not receive manual therapy. ⋯ Of 106 340 patients admitted for low back pain originally queried, only 75 patients (0.07%) received manual therapy, a markedly small number of patients. Outcomes may be reflective of the low effect size of manual therapy in a hospital setting or the inability to control for referral and hospital care patterns, thus disallowing appropriate matching.