Articles: low-back-pain.
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Lumbar provocation discography is an invasive diagnostic procedure to identify pain originating from within the lumbar discs. Specific morphological changes within the disc, classified as radial fissures, can be imaged following the injection of radiopaque contrast into the nucleus pulposus. The reproduction of concordant low back and/or referred somatic pain to the lower extremity under controlled conditions and the demonstration of annular radial tears are part of a spectrum of internal disc disruption that is separate from disc degeneration. A review of the validity and technique of lumbar discography as well as recently described causes of false positive responses are presented.
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J Spinal Disord Tech · Apr 2005
Clinical TrialLimited clinical utility of pain drawing in assessing patients with low back pain.
The aim of this study was to assess the use of pain drawing by studying its ability to identify patients with low back pain and abnormal psychological profile. The intraevaluator repeatability of the penalty point method of scoring of pain drawing was also evaluated. ⋯ Though there are differences in anxiety and depression scores in patients with normal and abnormal pain drawing, the performance characteristics of pain drawing are less than acceptable and therefore limit its use in clinical practice.
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Low back pain (LBP) is a common cause of lost work days and disability. In 2001, expenditure for back pain represented 11% of the total costs for short-term sick leave in Sweden, and about 13% of all early retirement pensions were granted for back problems, of which LBP is the most important symptom. The magnitude of LBP as a health problem justifies a closer look at its burden of illness to society. ⋯ The cost of illness due to low back pain was substantial, but does not appear to have risen during the last 10-15 years.
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The purpose of this study was to predict post-settlement pain intensity, psychological distress, disability, and financial struggle among African American (n=580) and non-Hispanic Caucasian (n=892) Workers' Compensation claimants with single incident low back injury. The study was a population-based telephone survey conducted in three population centers in Missouri. ⋯ The results suggest that African American race and lower SES-relative to Caucasian race and higher SES-are risk factors for poor outcomes after occupational low back injury. Mechanisms to explain these associations are discussed, including patient-level, provider-level, legal, and Workers' Compensation system-level factors.
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G Ital Med Lav Ergon · Apr 2005
[A new method of functional rehabilitation of patients with occupational disability caused by lumbar spine pathology].
Rehabilitation is reducing disability through an improvement of function, i.e. rehabilitation need always to be "functional". Nevertheless, like it happened in other fields where rehabilitation has not yet reached its maturity, in spinal pathologies it has usually been considered equal to conservative treatment, i.e. not surgical relief of pain. But relieving pain does not always mean to recover function: in fact, it has been proven that there are no long term good results treating symptomatically chronic low back pain (CLBP). ⋯ This treatment, named "functional rehabilitation", proved its efficacy also in randomised controlled trials (RCT). In the Nineties in Finland the outpatient version of this treatment for CLBP has been developed by "Documentation Based Care" (DBC), whose efficacy have also been documented in RCT: the efficiency of this last kind of treatment should be higher. DBC treatment is spreading around the world, and it recently reached Italy in Don Gnocchi.