Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study
A comparison of two short education programs for improving low back pain-related disability in the elderly: a cluster randomized controlled trial.
Cluster randomized clinical trial. ⋯ In institutionalized elderly, the handing out of the Back Book supported by a 20-minute group talk improves disability 6 months later, and is even more effective in those subjects with LBP.
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Surgical intervention for neck pain and low back pain may be of benefit to some patients. It should be considered, however, only in cases where medical management has failed and there is a clearly identifiable anatomic lesion that likely is the pain generator. Indications, preoperative evaluation, and common surgical procedures are reviewed.
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Our study was designed to document fiscal data for emergency department admissions for acute exacerbation of chronic back pain. ⋯ Emergency department care may be a costly venue for the management of chronic back pain. Because most patients obtain only short-term relief, they are likely to continue seeking urgent care intermittently until effective long-term pain management is widely available and reimbursable on an outpatient basis.
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Multicenter Study Clinical Trial
Efficacy and safety evaluation of once-daily OROS hydromorphone in patients with chronic low back pain: a pilot open-label study (DO-127).
To evaluate the safety, tolerability, and efficacy of once-daily osmotic controlled-release oral delivery system (OROS) hydromorphone in patients with chronic low back pain of moderate-to-severe intensity. ⋯ OROS hydromorphone may be an effective treatment for chronic low back pain of moderate-to-severe intensity. Adverse events were typical of those associated with opioid therapy.
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There has been growing interest among researchers and clinicians in the role of ambivalence over emotional expression (AEE) in adjustment to chronic illness. Because of the salience of anger in chronic low back pain, this condition provides a particularly good model in which to examine the role of AEE. This study examined the relation of AEE to pain and anger in a sample of 61 patients with chronic low back pain. Patients completed standardized measures of AEE, pain, and anger. Correlational analyses showed that patients who had higher AEE scores reported higher levels of evaluative and affective pain as well as higher levels of state and trait anger and the tendency to hold in angry thoughts and feelings. Mediational analyses revealed that most of the associations between AEE and pain, and AEE and anger, were independent of one another. These findings suggest that a potentially important relationship exists between AEE and key aspects of living with persistent pain. ⋯ This preliminary study suggests that there is a relation between ambivalence over emotional expression and pain and anger in patients with chronic low back pain. Patients who report greater conflict with regard to expressing emotions may be experiencing higher pain and anger.