Articles: low-back-pain.
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J Am Osteopath Assoc · Nov 2007
Case ReportsUsing image-guided techniques for chronic low back pain.
Image-guided spine intervention is used primarily for its precise diagnostic capabilities. This article reviews basic principles of the more common image-guided diagnostic techniques specifically as they relate to patients with low back pain. It also includes discussion of advanced modes of therapy, including spinal cord stimulation and intrathecal therapy, providing primary care physicians with an understanding of the primary indications for these therapeutic modalities. Two illustrative case presentations have been added to "refresh" this article, which was originally published in a supplement to the September 2005 issue of the JAOA and to further enhance primary care physicians' understanding of spinal intervention.
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The aim of the present study was to explore if (a) recurrent low back pain (LBP) has different symptomatologies in cases from occupations with predominantly sitting postures compared to cases from occupations involving dynamic postures and frequent lifting and (b) if in the two occupational groups, different factors were associated with the presence of recurrent LBP. Hundred and eleven female subjects aged between 45 and 62 years with a long-standing occupation either in administrative or nursing professions, with and without recurrent LBP were examined. An extensive evaluation of six areas of interest (pain and disability, clinical examination, functional tests, MR examination, physical and psychosocial workplace factors) was performed. ⋯ Neither MRI imaging nor self reported physical and psychosocial workplace factors discriminated between LBP cases and controls from both occupational groups. Although we used a battery of tests that have broad application in clinical and epidemiological studies of LBP, a clear difference in the pattern of symptoms between LBP cases from nursing and hospital administration personnel could not be ascertained. We conclude that there is no evidence for different mechanisms leading to non-specific, recurrent LBP in the two occupations, and thus no generalizable recommendations for the prevention and therapy of non-specific LBP in the two professions can be given.
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The aim of this study was to investigate the psychometric properties of the Norwegian version of the Tampa Scale of Kinesiophobia in patients with low back pain and in patients with more widespread pain distribution including low back pain. ⋯ The Norwegian translation of Tampa Scale of Kinesiophobia seems to reflect a unidimensional construct of kinesiophobia. The scale seemed to be quite robust across age and gender, and the response patterns to the items were similar in patients with low back pain and widespread pain distribution including low back pain.
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This study aimed to assess the accuracy and agreement between examiners when attempting to identify a single lumbar spinal level using passive intersegmental motion testing, a technique commonly used by physical therapists. Thirty-five adults were examined independently by an experienced and a novice clinician. Each examiner was asked to identify and note the interspace between the fifth lumbar vertebra and the first sacral vertebra, and to mark it. ⋯ Interobserver agreement was poor. A significant learning effect was found for the experienced examiner, with proportionately more correct levels identified during the second part of the study (79%) when compared to the first (31%). The results show that intersegmental motion testing is a relatively unreliable method of identifying the correct spinal level.
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Review Meta Analysis
Health care practitioners' attitudes and beliefs about low back pain: a systematic search and critical review of available measurement tools.
The attitudes and beliefs that health care practitioners (HCPs) hold about back pain have been shown to affect the advice they provide to patients seeking healthcare. In order to develop a questionnaire for a national survey of attitudes, beliefs and practice behaviour of HCPs about back pain, a systematic review of available measurement tools was undertaken. Measurement tools were identified from a systematic search of databases (Medline, Embase, CINAHL, Psychinfo, AMED and British Nursing Index) in the English language for papers published from January 1990 to October 2006. ⋯ PT have undergone the most thorough testing to date, but gaps in the properties of all the tools remain, particularly test-retest reliability and responsiveness. This review identified only five tools and demonstrated limited reporting of their validity and reliability. Further development and testing of existing tools should be a priority to ensure they are robust and valid measures of attitudes and beliefs of HCPs about back pain.