Articles: low-back-pain.
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To correlate MR and CT discography findings with pain response at provocative discography in patients with discogenic back pain. ⋯ Typical MR findings with concordant pain at discography include grade 4 or 5 disc degeneration and presence of a high intensity zone. Typical CT discography findings with concordant pain were fissured/ruptured discs and contrast extending into/beyond the outer annulus on CT.
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Comparative Study
Centralization: its prognostic value in patients with referred symptoms and sciatica.
Prospective, comparative cohort study. ⋯ Patients with sciatica and suspected disc herniation who have a centralization response to a mechanical evaluation will have significantly better outcomes. Patients who do not have centralization will be 6 times more likely to undergo surgery.
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Arch Phys Med Rehabil · Jun 2005
Factor structure of the pain disability index in workers compensation claimants with low back injuries.
To examine the factor structure of a telephone-administered Pain Disability Index (PDI) and the effects of race and sex on the PDI. ⋯ The results support use of the PDI as a bidimensional measure of pain-related disability, with strong psychometric properties. They also support its administration by telephone.
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Randomized Controlled Trial
Individual active treatment combined with group exercise for acute and subacute low back pain.
Randomized controlled trial. ⋯ The results indicate that the costs of this active back program are more than reimbursed as a consequence of earlier return to work.
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Practice Guideline Guideline
Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: injection therapies, low-back pain, and lumbar fusion.
In summary, there is no meaningful evidence in the medical literature that the use of epidural injections is of any long-term value in the treatment of patients with chronic low-back pain. The literature does indicate that the use of lumbar epidural injections can provide short-term relief in selected patients with chronic low-back pain. There is evidence that suggests that facet joint injections can be used to predict outcome after RF ablation of a facet joint. ⋯ No evidence exists to support the effectiveness of facet injections in the treatment of patients with chronic low-back pain. There is conflicting evidence suggesting that the use of local TPIs can be effective for the short-term relief of low-back pain. There are no data to suggest that TPIs with either steroids or anesthetics alone provide lasting benefit for patients suffering from chronic low-back pain.