Articles: low-back-pain.
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Comparative Study
[Central pain processing in chronic low back pain. Evidence for reduced pain inhibition].
A study of patients with low back pain (LBP) had revealed altered central pain processing. At an equal pain level LBP patients had considerably more neuronal activation in the somatosensory cortices than controls. In a new analysis of this dataset, we further investigated the differences in central pain processing between LBP patients and controls, looking for possible pathogenic mechanisms. ⋯ These findings support a dysfunction of the inhibitory systems controlled by the PAG as a possible pathogenic mechanism in chronic low back pain.
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Reg Anesth Pain Med · Sep 2006
Comparative StudyHealth-related quality of life in sacroiliac syndrome: a comparison to lumbosacral radiculopathy.
This study attempts to assess the intensity and quality of pain and health-related quality of life in patients with sacroiliac syndrome and to compare those constructs to patients with lumbar radiculopathy. ⋯ The results of this study suggest the following: (1) no true difference exists in the health-related quality of life or pain scores/descriptors between patients with SI syndrome or lumbar radiculopathy, or (2) the presence of comorbid spinal conditions confounds the ability of the SF-36 to detect disparities in health-related quality of life among differing etiologies of low-back pain, despite the use of rigorous diagnostic criteria, and/or (3) other factors besides the diagnostic categories of low-back pain (e.g., functional capability, psychological stress) may be primary determinants of health-related quality of life. To our knowledge, no other study has attempted to use the SF-36 to detect differences in health-related quality of life among patients with different spinal diagnoses.
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The objective of this study was to systematically review the literature to assess the efficacy of nonsurgical spinal decompression achieved with motorized traction for chronic discogenic lumbosacral back pain. ⋯ These data suggest that the efficacy of spinal decompression achieved with motorized traction for chronic discogenic low back pain remains unproved. This may be, in part, due to heterogeneous patient groups and the difficulties involved in properly blinding patients to the mechanical pulling mechanism. Scientifically more rigorous studies with better randomization, control groups, and standardized outcome measures are needed to overcome the limitations of past studies.
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Current therapies for sacroiliac joint (SIJ) dysfunction offer discouraging results in alleviating low back pain. The innervation and target nerves for radiofrequency denervation (RFD) of the SIJ remain unclear. We present a prospective case series on the treatment of intractable SIJ dysfunction with pulsed radiofrequency denervation (PRFD) of lateral branches from L4-S3. ⋯ PRFD of the lateral branch of the medial branch of L4, posterior primary rami of L5, and lateral branches S1 and S2 is an effective treatment for some patients with SIJ pain unresponsive to other forms of therapy.