Articles: low-back-pain.
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Population-based telephone survey in Missouri. ⋯ Race differences in diagnosis and surgery may help to explain why African Americans, relative to whites, receive lower workers' compensation medical expenditures, disability ratings, and settlement awards.
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A systematic search of three electronic databases was done to identify randomized controlled trials on the effect of written or audiovisual information in low back pain. ⋯ Information based on a biopsychosocial model is recommended in primary care to shift patient beliefs on low back pain. Nevertheless, information delivery alone is not sufficient to prevent absenteeism and reduce healthcare costs.
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Comparative Study
The attitudes to back pain scale in musculoskeletal practitioners (ABS-mp): the development and testing of a new questionnaire.
Little is known about practitioners' beliefs and attitudes to the treatment of low back pain, and whether these influence their clinical decisions, intervention strategies, and patient-centered outcomes. This study aimed to develop, test, and explore the underlying dimensions of a new questionnaire, the Attitudes to Back Pain Scale (ABS), in a specific group of clinicians, practitioners who specialize in musculoskeletal therapy. ⋯ The internal structure of the new questionnaire not only shows excellent psychometric properties and good face validity, but also has the added advantage of being developed with a specific clinical context in mind. Additional evaluation is required to fully describe the psychometric integrity of this instrument.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
The ACTION study: a randomized, open-label, multicenter trial comparing once-a-day extended-release morphine sulfate capsules (AVINZA) to twice-a-day controlled-release oxycodone hydrochloride tablets (OxyContin) for the treatment of chronic, moderate to severe low back pain.
This large, open-label, randomized, parallel-group, multicenter study compared two oral sustained-release opioids (SROs)--AVINZA (A-MQD), morphine sulfate extended-release capsules given once a day, and OxyContin (O-ER), oxycodone modified-release tablets given twice a day--in SRO-naive subjects ages 30 to 70 with chronic, moderate to severe low back pain. Of the 392 subjects enrolled and randomized, 266 (132 in the A-MQD group and 134 in the O-ER group) completed the opioid dose titration phase and entered an eight-week evaluation phase. During the evaluation phase, A-MQD achieved significantly better pain control than O-ER, as demonstrated by a greater decrease from baseline in pain scores obtained four times daily during weeks one, four, and eight (p = 0.002). ⋯ The incidence and severity of elicited opioid side effects were similar in the two groups. This trial demonstrated that once-daily A-MQD provides consistent around-the-clock pain relief in patients with low back pain. In patients who completed opioid dose titration, A-MQD was significantly better than O-ER for reducing pain and improving sleep, while requiring a lower daily opioid dose.
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J Spinal Disord Tech · May 2006
Controlled Clinical TrialMicrosurgical treatment of juxta facet cysts of the lumbar spine.
Juxta facet cysts are a common cause of low back and radicular pain. They are mostly associated with degenerative facet joints and spondylolisthesis. The study focuses on long-term outcomes after microsurgical treatment without fusion. ⋯ Conservative therapy does not adequately improve symptoms in patients with intraspinal juxta facet cysts and radicular signs. Juxta facet cysts can be treated effectively with a minimally invasive microsurgical approach. This may be of particular significance when the cysts are associated with spondylolisthesis, minimizing the risk of instability and the need for fusion. In a selected group of patients with persistent low back pain, fusion may become necessary to improve symptoms.