Articles: low-back-pain.
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Reg Anesth Pain Med · Sep 2006
Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control.
For diagnostic lumbar medial-branch blocks, fluoroscopic guidance is considered mandatory, but this technique comes with radiation exposure. The clinical feasibility of the ultrasound-guided lumbar medial-branch block has been demonstrated. We evaluated the success rate and validity of this new method by use of fluoroscopy controls in patients previously diagnosed with lumbar facet joint-mediated pain. ⋯ Ultrasound-guided lumbar medial-branch blocks can be performed with a high success rate. However, to be completely independent from fluoroscopy controls, this technique requires further studies regarding the detection of intravascular spread.
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African health sciences · Sep 2006
Disability associated with low back pain in Mulago Hospital, Kampala Uganda.
Low back pain is sufficiently disabling and a common cause of disability particularly during the productive middle years of adult life. Disability implies interference with daily activities. ⋯ Our results confirm that low back pain is a significant cause of disability affecting the productive middle years of adult life and causes significant disruption of daily activities including sleep and sex. The cost of lost work time, compensation and treatment for our setting is a knowledge gap that should be filled by further study. There is need for a community-based study to ascertain extent of the problem in at a wider population level.
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J Manipulative Physiol Ther · Sep 2006
ReviewInconsistent grading of evidence across countries: a review of low back pain guidelines.
The aim of this study was to report clinical treatment recommendations for low back pain (LBP) based on 5 international guidelines and best evidence from the Cochrane database of systematic reviews. ⋯ Treatment recommendations for nonspecific LBP, particularly spinal manipulation, remain inconclusive. Guideline developers need to consider guidelines in neighboring countries and reach consensus on how evidence is graded and incorporated into guidelines. Guidelines should continue to be regularly updated to incorporate new evidence and methods of grading the evidence.
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Comparative Study
Evidence-based practice for acute low back pain in primary care: patient outcomes and cost of care.
Provider adherence with clinical practice guidelines (CPGs) for acute low back pain (LBP) and its impact on clinical outcomes and cost are controversial. A panel and cross-sectional design was used to determine the rate of provider adherence to the Department of Defense/Veteran's Administration CPG for Acute LBP which included ergonomic and psychosocial intervention. The relationship among adherent care, patient satisfaction, general health, functional outcome, and cost was examined. ⋯ Multivariable regression analyses controlling for demographic variables and perceived health indicated that CPG adherence was related to better functional outcomes, Odds ratio (OR)=1.45 [95% CI=1.31-1.60] and lower healthcare costs (beta=-230.15, p<0.001). Cases receiving more adherent care also reported higher levels of patient satisfaction (beta=0.09, p<0.05) and general health, OR=1.44 [95% CI=1.29-1.60]. Higher levels of adherent care which included efforts to address both ergonomic and psychosocial factors in the course of acute back pain were related to better clinical outcomes and lower costs.
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Randomized Controlled Trial Comparative Study
Interferential and horizontal therapies in chronic low back pain: a randomized, double blind, clinical study.
Chronic Low Back Pain (CLBP) is one of the most frequent medical problems. Electrical nerve stimulation is frequently used but its efficacy remains controversial. ⋯ This randomized double-blind controlled study provides the first evidence that IFT and HT therapy are significantly effective in alleviating both pain and disability in patients with CLBP. The placebo effect is remarkable at the beginning of the treatment but it tends to vanish within a couple of weeks.