Articles: low-back-pain.
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Anecdotal reports and limited data suggest that the use of spinal injections is increasing, despite equivocal evidence about efficacy. ⋯ Lumbosacral injections increased dramatically in the Medicare population from 1994 to 2001. Less than half were performed for sciatica or radiculopathy, where the greatest evidence of benefit is available. These findings suggest a lack of consensus regarding the indications for ESIs and are cause for concern given the large expenditures for these procedures.
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Randomized Controlled Trial
Active exercise, education, and cognitive behavioral therapy for persistent disabling low back pain: a randomized controlled trial.
A randomized controlled trial. ⋯ This intervention program produces only modest effects in reducing LBP and disability over a 1-year period. The observation that patient preference for treatment influences outcome warrants further investigation.
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Objective. Our objective was to determine the efficacy of peripheral nerve field stimulation (PNFS) for the treatment of chronic lower back pain. PNFS is becoming increasingly recognized as a safe, minimally invasive, and easily reversible treatment for a variety of chronic pain conditions. Chronic low back pain is a common cause of disability and one that is difficult to treat effectively. ⋯ Results. In each case presented here, PNFS enabled patients to decrease their pain medication and increase their level of activity. The patients all reported reduction in pain as measured by visual analog scale scores and an improved quality of life. Conclusion. We conclude that PNFS is a safe and effective alternative treatment for patients with chronic low back pain, and should be considered in this population.
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Multicenter Study Clinical Trial
The LBP patient perception scale: a new predictor of LBP episode outcomes among primary care patients.
To describe a new tool designed to capture patients' perception of their low back pain (LBP) episodes-the patient perception scale (PPS) and test its ability to predict episode outcomes. ⋯ The PPS-pt could potentially be used as part of the standard initial patient evaluation of new LBP patients, as a proxy for "yellow flags" (markers of psychosocial risk) where a positive score might be the equivalent to high-risk identification. The apparent advantage of this scale is its brevity and simplicity of administration. The separation, through this scale of pain episodes into simple and complex LBP might be a useful tool for helping direct resources and avoiding chronicity.
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J Spinal Disord Tech · Jul 2007
Clinical TrialPsychophysical measurements during lumbar discography: a heart rate response study.
Prospective clinical data analysis. ⋯ Lumbar discography induces positive HR response only in positive discograms. Although there is no immediate practical application of these results, 2 implications may deserve future research: (a) correlation of HR response with surgical and intradiscal electrotherapy treatment outcomes; (b) evaluation of HR measurement in cases of false-positive results (concordant pain on discography but no HR response).