Articles: low-back-pain.
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Low back pain is considered to fluctuate over time, and related prognostic factors may behave similarly, therefore classification of prognosis may be affected by timing of assessment. We aimed to investigate the implications of timing of assessment of prognosis in low back pain. In a prospective cohort of primary care low back pain consulters aged 30-59 years, 359 returned questionnaires at baseline, one-month and one-year. ⋯ Presence of the indicators at both time points was associated with even higher risk; people with persistent high pain intensity had 15 times the risk of a poor outcome (relative risk 15.1; 95% confidence interval 6.7-33.8) compared with people not reporting high pain at either point. Combining information on prognostic indicators from two time points provides better classification of low back pain patients' eventual outcome than a single measurement alone. This increased accuracy in predicting prognosis is relevant to both clinical and research practice.
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A 5-year prospective cohort study was conducted of men and women seeking care for a new period of low back pain (LBP). ⋯ Over a 5-year period, both men and women who had sought care for LBP reported a decrease in pain and disability; however, only a few were fully restored. In this study, we found no effect of nonspecific physical exercise on recovery from LBP in men and women.
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Zhonghua Wai Ke Za Zhi · Dec 2006
[The application of lumbar discography in the diagnosis and treatment of the discogenic low back pain].
To investigate the diagnostic value of lumbar discography in discogenic low back pain and the effects of intervertebral fusion surgery. ⋯ It is concluded that the discography is moderately sensitive in the diagnosis of discogenic low back pain. Furthermore, the short term follow-up reveals that operative group has better pain relief than conservative group.
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Randomized Controlled Trial Multicenter Study Comparative Study
Oxytrex minimizes physical dependence while providing effective analgesia: a randomized controlled trial in low back pain.
Physical dependence or withdrawal is an expected effect of prolonged opioid therapy. Oxytrex (oxycodone + ultralow-dose naltrexone) is an investigational drug shown here to minimize physical dependence while providing strong analgesia with twice-daily dosing. In this 719-patient, double-blind, placebo- and active-controlled Phase III clinical trial in chronic low back pain, patients were randomized to receive placebo, oxycodone qid, or oxytrex qid or bid. Each oxytrex tablet contains 1 microg naltrexone; oxytrex bid and qid treatments provide 2 and 4 microg naltrexone/day, respectively. Following a washout, patients with pain >or=5 on a 0-10 scale were dose-escalated weekly from 10 up to 80 mg/day until reaching adequate pain relief (
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Low back pain is a common complaint in the primary care setting. Although most patients with acute low back pain will improve with conservative treatment, back pain often recurs, and a subset of patients will progress to chronic and sometimes disabling symptoms. ⋯ The benefit of medications, including nonsteroidal anti-inflammatory drugs, analgesics, and possibly antidepressants or muscle relaxants, must be weighed against potential adverse effects. There is insufficient evidence regarding the effectiveness of many of the available therapies for chronic low back pain, and well-designed, randomized controlled trials are needed to clarify the role of these treatments.