Articles: low-back-pain.
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The Functional Rating Index (FRI) was developed to provide an assessment instrument which has not only clinical usefulness but also quantifies the patient's current state of pain and dysfunction in a reliable and valid manner for spinal conditions. There is no study on the FRI applied to older people with low back pain (LBP). The primary aim of this study was to evaluate the validity and reliability of the FRI in older people with LBP. ⋯ In this preliminary report, the FRI appears to be easy to administer, seems to have significant validity and reliability, and may be useful in geriatric assessment of older people with LBP.
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J Spinal Disord Tech · Feb 2004
The external fixator: a tool for evaluation of complex low back pain problems.
The selection of patients with low back pain for fusion is especially difficult when previous surgical interventions failed and/or invasive tests (discograms, facet blocks) do not allow or do not clearly identify the painful motion segment. Test fixation with an external fixator may mimic a definite internal fixation, such as a fusion, and may help select patients for a more favorable result. The purpose of the study was to clarify if temporary back pain relief by external fixation is predictive for back pain relief after final internal fixation and fusion. ⋯ The external fixator as a tool for evaluation of patients with low back pain is an expensive measure with a considerable complication risk and only justified in selected patients when any other measure fails to assess and evaluate a patient's situation. If the test fixation reveals no benefit, the patients will remain in a bad situation whatever the therapeutic measure will be. Therefore the main value of the external fixator assessment is the selection of these patients that should not undergo surgery. A positive test fixation means a 72% chance for a satisfactory outcome at least two years after surgery, whereas without surgery the chance for some spontaneous improvement is 57% if the test immobilization did show some improvement. With respect of the "negative" selection of this group of patients (complex history, previous interventions) in our as well as in others series, the obtained results seem acceptable and the use of this invasive diagnostic measure in this group of patients seems justified. Statistical analysis did not show differences of significance as the numbers in the individual groups was too small.
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This study evaluated the relation of particular aspects of pain-related anxiety to characteristics of chronic pain distress in a sample of 76 individuals with low-back pain. Consistent with contemporary cognitive-behavioral models of chronic pain, the cognitive dimension of the Pain Anxiety Symptoms Scale (PASS; McCracken, Zayfert, and Gross, 1992, Pain 50:67-73) was uniquely predictive of cognitive-affective aspects of chronic pain, including affective distress, perceived lack of control, and pain severity. In contrast, the escape and avoidance dimension of the PASS was more predictive of behavioral interference in life activities. Overall, the findings are discussed within the context of identifying particular pain-related anxiety mechanisms contributing to differential aspects of pain-related distress and clinical impairment.
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Ann Readapt Med Phys · Feb 2004
Clinical Trial[Interest of the criteria of Cochin to select patients with significant relief of low back pain after corticosteroid facet joint injections: a prospective study].
The seven Criteria of Cochin (CC), clinical descriptive criteria of low back pain (LBP), have been shown to be able to select patients whose LBP would respond well to facet joint anesthesia. ⋯ CC seems to be an effective test to select patients whose LBP would respond well to CFJI.
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Clinical observation suggests a frequent coincidence of back pain (BP) and fibromyalgia (FMA). Based on data from a population survey on back pain we studied the hypothesis of FMA being a frequent underlying condition of BP. We additionally studied the association of the severity of back pain and both chronic widespread musculoskeletal pain and active tender points. ⋯ Our data do not support the hypothesis of FMA as a frequent underlying condition of BP. We found, however, a close correlation between BP grade (and amount of distress) and tender points count. More severe forms of BP imply an increasing allodynia/hyperalgesia, itself being associated with a higher amount of somatic and psychological distress (Chronic severe) back pain seems to be more than simply pain in the back.