Articles: low-back-pain.
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Low back pain (LBP) is a major problem of public health. Chronic pain is the most difficult to treat and the most expensive. The way patients cope with their pain may influence its outcome. ⋯ Besides somatic factors, psychosocial predictors of LBP chronic evolution may be identified. Both aspects must be taken into account in order to prevent chronic pain. Perhaps cognitive-behavior therapy may help LBP patients to cope with pain in a better way.
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Bmc Musculoskel Dis · Jan 2006
Multicenter Study Comparative StudyLumbar segmental mobility disorders: comparison of two methods of defining abnormal displacement kinematics in a cohort of patients with non-specific mechanical low back pain.
Lumbar segmental rigidity (LSR) and lumbar segmental instability (LSI) are believed to be associated with low back pain (LBP), and identification of these disorders is believed to be useful for directing intervention choices. Previous studies have focussed on lumbar segmental rotation and translation, but have used widely varying methodologies. Cut-off points for the diagnosis of LSR & LSI are largely arbitrary. Prevalence of these lumbar segmental mobility disorders (LSMDs) in a non-surgical, primary care LBP population has not been established. ⋯ LSMDs are a valid means of defining sub-groups within non-specific LBP, in a conservative care population of patients with RCLBP. Prevalence was higher using the normalised within-subjects contribution-to-total-lumbar-motion approach.
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Clin Occup Environ Med · Jan 2006
ReviewLumbar spine injection and interventional procedures in the management of low back pain.
Lumbar spine injections play a role in the evaluation and treatment of low back pain and lumbar radiculopathy. These injection procedures have been demonstrated to be effective in determining the pain generator for low back pain. ⋯ Current evidence validates that these injections provide temporary relief of low back and radicular leg pain up to several months, if not longer. This duration of pain relief creates an opportunity to maximize rehabilitation efforts while symptoms are minimal.
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Use of multicontact electrodes and programmable implanted pulse generators has increased the efficacy of spinal cord stimulation for pain. Some investigators find dual column electrodes advantageous for difficult-to-treat axial low back pain, but we have reported significantly improved measures with a single percutaneous midline electrode vs. dual percutaneous electrodes and even better results with an insulated, 1 × 4, midline electrode. ⋯ Compared with the 2 × 8, the 1 × 4 resulted in marginally better patient-rated (109%, p = 0.06) and computer-calculated pain/paresthesia overlap (107%, p = 0.17); higher scaled amplitude to cover the low back (106%, NS); and significantly lower voltage (78%, p = 0.0004), increased extraneous coverage (141%, p = 0.0000), and improved symmetry (25%, p = 0.001). Thus, we observed no significant technical advantage for the insulated 2 × 8 in treating axial low back pain.
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Comparative Study
A minimal clinically important difference was derived for the Roland-Morris Disability Questionnaire for low back pain.
To compare methods commonly used to derive minimal important differences and recommend a rule for defining patients as clinically improved on the low back pain-specific Roland-Morris Disability Questionnaire (RMDQ). ⋯ A minimal clinically important difference is derived that is clinically relevant, incorporates the measurement error of the RMDQ, and allows subjects with different grades of severity to improve.