Articles: low-back-pain.
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Comparative Study
Differentiating sensory and affective-sensory pain descriptions in patients undergoing magnetic resonance imaging for persistent low back pain.
The study design is a cross-sectional survey with psychometric analysis. The objective is to determine the validity of a modified version of the Short-Form McGill Pain Questionnaire (SF-MPQ). The SF-MPQ has been widely used to differentiate between reports of sensory and affective pain. ⋯ Correlations with measures of pain intensity and the RM were significant, but slightly lower, for the subscales of the modified 2-factor solution (0.26-0.40) than for the subscales of the previously described 2-factor solutions (0.34-0.45). The MSF-MPQ can be used as a brief tool to differentiate the language used to describe pain in patients who are undergoing lumbar MRI. The evidence indicates that this clinical tool can be used to categorize how these patients describe their pain and potentially may be very valuable in determining the optimal course of treatment.
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The use of epidural steroid injections as a treatment for patients with degenerative lumbar scoliotic spinal stenosis and radiculopathy has received sparse attention in the literature. Even though it has been reported that patients with scoliosis may respond differently than other patient groups to conservative therapeutic interventions for low back pain and radiculopathy, patients with scoliosis have rarely, if ever, been excluded from clinical studies of epidural steroid injections. To date, there are no studies investigating the efficacy of fluoroscopic transforaminal epidural steroid injections as a treatment for patients with radiculopathy and radiographic evidence of degenerative lumbar scoliotic stenosis. ⋯ Fluoroscopic transforaminal epidural steroid injections appear to be an effective nonsurgical treatment option for patients with degenerative lumbar scoliotic stenosis and radiculopathy and should be considered before surgical intervention.
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J Pain Symptom Manage · Jul 2004
ReviewA comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain.
A systematic review involving 50 randomized controlled trials (4,863 patients) published since 1980 was undertaken with the objective of assessing efficacy and safety of low back pain (LBP) medications. The methodological quality of each trial was evaluated based on a standardized system. ⋯ Available evidence supported the effectiveness of non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) in acute and chronic LBP, of muscle relaxants in acute LBP, and of antidepressants in chronic LBP; safety results were heterogeneous. More rigorously designed trials should be implemented to establish comparative efficacy and safety of drugs used to treat chronic and acute LBP.
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Work and activity-specific fear-avoidance beliefs have been identified as important predictor variables in relation to the development of, and treatment outcome for, chronic low back pain. The objective of this study was to provide a cross-cultural German adaptation of the Fear-Avoidance Beliefs Questionnaire (FABQ) and to investigate its psychometric properties (reliability, validity) and predictive power in a sample of Swiss-German low back pain patients. Questionnaires from 388 operatively and non-operatively treated patients were administered before and 6 months after treatment to assess: socio-demographic data, disability (Roland and Morris), pain severity, fear-avoidance beliefs, depression (ZUNG) and heightened somatic awareness (MSPQ). ⋯ Prognostic regression analysis replicated the findings for work loss. The cross-cultural German adaptation of the FABQ was very successful and yielded psychometric properties and predictive power of the scales similar to the original version. The inclusion of fear-avoidance beliefs as predictor variables in studies of low back pain is highly recommended, as they appear to have unique predictive power in analyses of disability and work loss.
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Preventive medicine · Jul 2004
Randomized Controlled Trial Clinical TrialA randomized controlled clinical trial for low back pain treated by acupressure and physical therapy.
Although acupressure has been reported to be effective in managing various types of pain, its efficacy in relieving pain associated with low back pain (LBP) remains unclear. The aim of this study is to compare the efficacy of acupressure with that of physical therapy in reducing low back pain. ⋯ Our results suggest that acupressure is another effective alternative medicine in reducing low back pain, although the standard operating procedures involved with acupressure treatment should be carefully assessed in the future.