Articles: low-back-pain.
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The patient with neurogenic claudication resulting from lumbar spinal stenosis who fails to experience satisfactory relief from nonsurgical measures has limited treatment options. Lumbar epidural steroid injections and surgical laminectomy are generally accepted alternatives for the patient with moderate to severe symptoms. ⋯ Sufficient medium- and long-term data are lacking, however, particularly with respect to durability of symptomatic relief and the risk of device migration or dislocation. Although interspinous process spacers are a promising new technology, the results of longer-term clinical follow-up studies are needed to more clearly define their role in the management of lumbar spinal stenosis.
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There is limited knowledge on prognostic factors for developing chronic low back pain (LBP) at an early stage of LBP. The objectives of this study were to investigate the clinical course of pain and disability, and prognostic factors for non-recovery after 1-year, in patients seeking help for the first time due to acute LBP. An inception cohort study included 123 patients with acute LBP lasting less than 3 weeks and consulting primary care for the first time. ⋯ The proportions with sickness absence due to LBP at 6, 9, and 12 months were 7%, 8%, and 9%, respectively. At 12 months, 17% of patients had not fully recovered. Multivariate logistic regression analyses showed that high scores on a psychosocial screening (acute low back pain screening questionnaire) and emotional distress (Hopkin's symptom check list) were significantly associated with non-recovery at 12 months, with odds ratios of 4.4 (95% confidence interval 1.1-17.4) and 3.3 (1.1-10.2), respectively.
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Arch Phys Med Rehabil · Apr 2007
Comparative StudyPrevalence of facet joint pain in chronic low back pain in postsurgical patients by controlled comparative local anesthetic blocks.
To evaluate the prevalence of facet joint pain in patients with chronic low back pain (CLBP) after surgical intervention(s). ⋯ Facet joints are clinically important pain generators in a small but significant proportion of patients with recurrent CLBP after various surgical intervention(s).
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A prospective, case-control design. ⋯ DFV was useful for discriminating between individuals with and without LBP based on kinematic parameters. Disruptions in how the motion occurred during midrange motions were more diagnostic for LBP than range of motion variables. Cross validation of the model is required.
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Comparative Study
Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
Experimental, biomechanical study to determine the kinetics of the lumbar spine and hips during sit-to-stand and stand-to-sit. ⋯ Back pain subjects exhibit compensatory movements and altered load sharing strategies during the sit-to-stand and stand-to-sit activities. Exercise therapy should take account of these changes so that the normal kinematic and kinetic characteristics of the spine and hips can be restored.