Articles: low-back-pain.
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Neuropathic pain and radicular low back pain both have a major impact on human health worldwide. Microarray gene analysis on central nervous system tissues holds great promise for discovering novel targets for persistent pain modulation. ⋯ These two models of persistent pain produce similar allodynic outcomes but produce differential gene expression. These results suggest that diverging mechanisms lead to a common behavioral outcome in these pain models. Furthermore, these distinct pathophysiologic mechanisms in neuropathic versus radicular pain may implicate unique drug therapies for these types of chronic pain syndromes.
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Arch Phys Med Rehabil · Jun 2006
Changes in disability following physical therapy intervention for patients with low back pain: dependence on symptom duration.
To assess the impact of symptom duration on functional outcome, functional improvement, pain, and patient perception of recovery after a physical therapy (PT) program for low back pain (LBP) and to determine what variables are significantly associated with improved function. ⋯ Patients showed improvements in function following a rehabilitation program for LBP. The functional improvement score is influenced by age, symptom duration, and inclusion of mobilization/manipulation and strengthening and flexibility exercises.
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Photomed Laser Surg · Jun 2006
Salvage operation for persistent low back pain and sciatica induced by percutaneous laser disc decompression performed at outside institution: correlation of magnetic resonance imaging and intraoperative and pathological findings.
We identified several problems associated with percutaneous lumbar disc decompression (PLDD) based on a study of patients who required salvage operations for complications after undergoing PLDD at an outside institution. ⋯ PLDD is associated with significant risk of disc, end-plate, and nerve root injuries, contrary to the general belief that the procedure is minimally invasive. Our findings highlight the need for careful diagnosis and sufficient technical skill when selecting PLDD as a treatment option.
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This paper presents an in-depth, idiographic study exploring the personal experience of chronic benign low back pain in relation to the participant's body and sense of self. Semi-structured interviews were conducted with patients and the resultant transcripts subjected to interpretative phenomenological analysis. ⋯ The complex and paradoxical relationship between the body, chronic pain and the self is explored and evidence is provided to argue that the embodied unpleasantness of chronic pain involves an assault upon and a defence of a preferred or desirable self. The results are considered in relation to relevant themes in the extant literature.
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Since the first injection of chymopapain in 1963, percutaneous intradiscal therapies have been used to treat discogenic back and leg pain. The percutaneous discectomy techniques treat contained disc herniations not by resecting the prolapsed disc material but rather through central decompression of the disc. By removing a small volume of tissue from the disc nucleus, a large reduction in overall disc pressure is achieved with consequent relief of neural compression. ⋯ Annuloplasty techniques, such as IntraDiscal Electrothermal Therapy (IDET) and discTRODE, have been developed over the past decade that thermally treat the lesions of IDD. Although the therapeutic mechanisms of thermal annuloplasty have yet to be fully elucidated, research studies demonstrate that the procedure can be effective for appropriately selected patients with degenerative disc disease characterized by discographically proven painful annular fissures. Other novel intradiscal therapies are emerging for percutaneous treatment of discogenic pain and await more widespread clinical evaluation.