Articles: low-back-pain.
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Kathmandu Univ Med J (KUMJ) · Oct 2005
Our experience with epidural steroid injections in management of low backpain and sciatica.
Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of the region. The initial treatment of Low back pain is conservative. Epidural steroid injection is being slowly established as are liable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid in the management of low back pain cases coming to the orthopaedic department of Manipal Teaching Hospital. ⋯ Epidural Steroid Injection is a safe and effective mode of treatment of Low Back Pain. It provides painfree period to enable the patient for physiotherapy which helps in early recovery.
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The main objective of the present study was to investigate the benefits of exposure to a variety of movements versus exposure to the same movements on overprediction of pain and behavioural performance on a final behavioural test in a sample of chronic low back pain (CLBP) patients. Eighty-four CLBP patients were requested to perform four behavioural tests. Patients were assigned to two experimental conditions. ⋯ Furthermore, pain-related fear and pain catastrophizing showed to be unique predictors of the peak torque of the final behavioural test. No support was found for our hypothesis that varied exposure facilitates generalization of exposure effects. Possible reasons for the failure to find an advantageous effect of varied-stimulus exposure and ideas for future research are discussed.
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Comparative Study
Repeatability of stature measurements in individuals with and without chronic low-back pain.
Measurements of reduction in stature have been used to compare spinal loading in chronic low-back pain (CLBP) and asymptomatic populations. Whether there are any differences in the repeatability of stature measurements, between those with and without CLBP, is not known. This investigation aimed to determine the repeatability of stature measurements in those with (n = 12) and without (n = 12) CLBP, and to establish if the ability to produce repeatable measurements is retained after a specific timeframe. ⋯ Intraclass correlation coefficients (ICC) demonstrated good levels of repeatability for all stature measurements obtained from the participants and the values for Standard error of the measurement (SEM) improved as the mean SD decreased with each measurement set. Investigators should have confidence in the ability of those with and without CLBP to produce equally repeatable stature measurements with appropriate prior practice. The second session of testing demonstrated that both groups had retained the ability to achieve the desired level of repeatability (SD < or = 0.5 mm) 2 weeks later without further practice.
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Caudal epidural steroid injections are often used for low back pain. Fluoroscopic guidance has been frequently cited as a requirement for this procedure. ⋯ We detected intravenous leakage of the drug in 4 cases of 10 when real-time fluoroscopic imaging was used. Thus, real-time imaging may be recommended in addition to routine fluoroscopic guidance for caudal epidural procedures, as it may improve efficacy and safety by assuring accurate drug deposition.
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Low back pain (LBP) is a major physical and socioeconomic entity. A significant percentage of LBP is attributable to internal disc disruption. The management of internal disc disruption has traditionally been limited to either conservative treatment or spinal fusion. ⋯ PNT represents a new less invasive technique for the treatment of discogenic pain, but limited research is available to determine long-term clinical efficacy. IDET and PNT are potentially beneficial treatments for internal disc disruption in carefully selected patients as an alternative to spinal fusion. More basic science and clinical research with long-term follow-up evaluation is necessary.