Articles: low-back-pain.
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Complement Ther Med · Jun 2008
Randomized Controlled TrialAcupuncture for acute non-specific low back pain: a pilot randomised non-penetrating sham controlled trial.
A pilot study to assess the feasibility of a trial to investigate the efficacy of acupuncture compared to placebo needling for the treatment of acute low back pain (LBP). As part of this, the study was designed to establish the credibility of the placebo control, and to provide data to inform a power analysis to determine numbers for a future trial. ⋯ This study has demonstrated the feasibility of a randomized controlled trial of penetrating needle acupuncture compared to a non-penetrating sham for the treatment of acute LBP in primary care; 120 participants would be required in a fully powered trial. The placebo needle used in this study proved to be a credible form of control.
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AJNR Am J Neuroradiol · Jun 2008
Randomized Controlled TrialEffects of diagnostic information, per se, on patient outcomes in acute radiculopathy and low back pain.
We conducted a prospective randomized study of patients with acute low back pain and/or radiculopathy to assess the effect of knowledge of diagnostic findings on clinical outcome. The practice of ordering spinal imaging, perhaps unintentionally, includes a large number of patients for whom the imaging test is performed for purposes of reassurance or because of patient expectations. If this rationale is valid, one would expect to see a measurable effect from diagnostic information, per se. ⋯ Patient knowledge of imaging findings do not alter outcome and are associated with a lesser sense of well-being.
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Animal experiments and studies in humans clearly show that the relation between pain (acute and chronic) and sleep quality is two-way: sleep disorders can increase pain, which in turn may cause sleep disorders. Sleep disorders and chronic low back pain are frequent health problems and it is unsurprising that the two can co-exist. This study was conducted to evaluate if sleep disorders and chronic pain associated are more frequently than one would expect. ⋯ Sleep disorders were greater when the impact of CLBP on daily life (the four aspects of the DPQ) was greater [P < 0.0001]). The sleep of the patients with CLBP was significantly altered compared with that of the healthy controls, in proportion to the impact of low back pain on daily life. Our findings do not indicate whether sleep disorders are a cause or a consequence of CLBP.
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Best Pract Res Clin Rheumatol · Jun 2008
ReviewA best-evidence review of diagnostic procedures for neck and low-back pain.
This chapter aims to present an overview of the best available evidence on diagnostic procedures for neck and low-back pain. Relatively little is known about the accuracy of such procedures. Although most spinal conditions are benign and self-limiting, the real challenge to the clinician is to distinguish serious spinal pathology or nerve-root pain from non-specific neck and low-back pain. ⋯ In conclusion, during the history, the clinician can accurately identify sciatica due to disc herniation, as well as serious pathology. There is sufficient evidence regarding the accuracy of specific tests for identifying sciatica or radiculopathy (such as the straight-leg raise) or certain orthopaedic tests of the neck. Plain spinal radiography in combination with standard laboratory tests is useful for identifying pathology, but is not advisable for non-specific neck or low-back pain.
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The purpose of the study was to explore the construct validity of three versions of the Oswestry Disability Questionnaire for low back pain using Rasch analysis. The three versions of the ODQ share 9 items and differ on one other. About 100 patients with non-specific low back pain seeking physiotherapy treatment at hospital outpatient departments and physiotherapy private practices completed the 12 Oswestry items as part of a battery of questionnaires. ⋯ The third version, in which Sex Life is replaced by Changing Degree of Pain, did not fit the model (chi(2)P=.006) and the Changing Degree of Pain item was misfitting (residual 2.34, P=.007). These findings suggest that either of the first two of the three versions of this widely used low back pain outcome measure should be selected over the third. Users should also be aware that for some items the rating scale steps do not perform as intended.