Articles: low-back-pain.
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Prospective inception cohort. ⋯ There is evidence for the validity of a single bothersomeness question as a measure of LBP severity. It has the potential to provide a practical standard scheme for classifying patients with LBP in clinical practice. However, further work is needed to clarify its usefulness in a clinical setting.
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A reliability study of the Modic classification. ⋯ We have shown that the classification is both reliable and reproducible. It is simple and easy to apply for observers of varying clinical experience. We therefore recommend its use in clinical research and practice.
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To evaluate whether a perceived decline in the level of physical activity after the onset of pain (PAD) is more appropriate in the explanation of disability as compared to the actual level of physical activity (PAL) in patients with sub-acute back pain. ⋯ The perceived decline in physical activity, rather than the current physical activity itself is important in the evaluation of the impact of activity related changes on disability in low back pain.
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Health Technol Assess · Aug 2005
Randomized Controlled Trial Multicenter Study Comparative StudyLonger term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain.
To test whether patients with persistent non-specific low back pain, when offered access to traditional acupuncture care alongside conventional primary care, gained more long-term relief from pain than those offered conventional care only, for equal or less cost. Safety and acceptability of acupuncture care to patients, and the heterogeneity of outcomes were also tested. ⋯ Traditional acupuncture care delivered in a primary care setting was safe and acceptable to patients with non-specific low back pain. Acupuncture care and usual care were both associated with clinically significant improvement at 12- and 24-month follow-up. Acupuncture care was significantly more effective in reducing bodily pain than usual care at 24-month follow-up. No benefits relating to function or disability were identified. GP referral to a service providing traditional acupuncture care offers a cost-effective intervention for reducing low back pain over a 2-year period. Further research is needed to examine many aspects of this treatment including its impact compared with other possible short-term packages of care (such as massage, chiropractic or physiotherapy), various aspects of cost-effectiveness, value to patients and implementation protocols.
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Multicenter Study Comparative Study
The transition from acute to subacute and chronic low back pain: a study based on determinants of quality of life and prediction of chronic disability.
Follow-up study. ⋯ LBP influences disability and quality of life more than RP. Disability is predicted by pain duration and quality of life is predicted by disability, but pain severity predicts neither one of them. Changes related to determinants of disability and quality of life, and to the prediction of chronic disability, appear 14 days after the onset of pain, supporting that cutoff point for considering a patient as being subacute.