Articles: low-back-pain.
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J Altern Complement Med · Jun 2008
Randomized Controlled TrialA comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic.
To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor. ⋯ This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.
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Arch Phys Med Rehabil · Jun 2008
The relationship between repeated epidural steroid injections and subsequent opioid use and lumbar surgery.
To evaluate whether the use of epidural steroid injections (ESIs) is associated with decreased subsequent opioid use in patients in the Department of Veteran's Affairs (VA) and to determine whether treatment with multiple injections are associated with decreased opioid use and lumbar surgery after ESIs. ⋯ Opioid use did not decrease in the 6 months after ESIs. In this population, patients who received multiple injections were more likely to start taking opioids and to undergo lumbar surgery within the 6 months after treatment with ESIs. These findings are concerning because our data suggest that ESIs are not reducing opioid use in this VA population.
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Occupational medicine · Jun 2008
Managing low back pain: knowledge and attitudes of hospital managers.
Low back pain (LBP) is a major cause of work-related disability. Despite an increasing emphasis on the role of employers and workplace managers in reducing work disability, little research has been conducted in this area. ⋯ Hospital line managers' knowledge of the evidence regarding their role in LBP management needs to be improved. Managers believed better information, improved staff resources and easier access to health and ergonomic services would facilitate their management of workers with LBP.
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This study examines the relationship between anxiety, depression and pain intensity in patients with low back pain who are newly admitted to an acute care hospital setting. ⋯ The results of this study showed that anxiety and depression are not only associated with pain intensity but that they also, partly, predict pain intensity in patients with low back pain who are newly admitted to an acute care hospital. Relevance to clinical practice. The results of this study support the assessment of and intervention in anxiety and depression symptoms in the provision of pain-relief nursing treatment in patients with low back pain who are admitted to acute care hospitals.
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Review Meta Analysis
Doctors' attitudes and beliefs regarding acute low back pain management: A systematic review.
The aim of this systematic review was to determine the attitudes and beliefs of doctors to acute low back pain, and the factors that influence these. The review comprised three phases: a methodological assessment of databases (Medline, EMBASE, Psychinfo, BIOSIS, CINAHL, and the Cochrane Central Register of Controlled Trials) identified potential papers; these were screened for inclusion criteria by two independent reviewers, the extraction of data and the rating of internal validity and strength of the evidence, using valid and reliable scales from accepted papers. Themes were then identified from the accepted literature. ⋯ There was inconsistent evidence that demographic factors (age) and level of education impacted doctors' attitudes and beliefs. Strategies to address/ modify these attitudes and beliefs are required, as in some cases they are at odds with guideline recommendations. Long term, these changes in these areas have the potential to maximise patient-care, and reduce costs to health services.