Articles: low-back-pain.
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Randomized Controlled Trial Clinical Trial
The effect of opioid analgesia on exercise test performance in chronic low back pain.
The effect of opioid analgesia on tests of muscular function in chronic low back pain (CLBP) is unknown. Twenty-eight subjects with CLBP of at least moderate intensity performed the Sorensen isokinetic exercise test once after receiving 1 microg/kg fentanyl intravenously and once after placebo in a randomized-order double-blind crossover design. Naloxone 3 microg/kg was administered after the fentanyl phase. ⋯ We presume that the pain relief resulted in increased test performance. Our result is at odds with those of randomized trials which have failed to demonstrate increased function following the treatment of pain with opioid analgesics. This highlights the complexity of the interaction between pain, analgesia and changes in function.
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Clinical biomechanics · Nov 2003
Clinical TrialForce and time recording for validating the sacroiliac distraction test.
The present aim was to investigate whether applied force and time interval of force exposure during the sacroiliac distraction test could discriminate subjects with sacroiliitis pain from healthy subjects. ⋯ There is a need for objective evaluation methods in manual tests that are easy to perform. Recording force and its time interval may be a step towards standardising pain-provocation sacroiliac joint tests.
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Comparative Study
Compliance with clinical practice guidelines in family physicians managing worker's compensation board patients with acute lower back pain.
Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain. ⋯ Recently published clinical practice guidelines regarding the management of patients with acute mechanical lower back pain have not been fully implemented into the patterns of practice of the family physicians.
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Randomized Controlled Trial Comparative Study Clinical Trial
Acupuncture in the management of chronic low back pain: a blinded randomized controlled trial.
To assess the efficacy of acupuncture in the treatment of chronic low back pain. ⋯ Further research is necessary to fully assess the efficacy of this treatment in combating chronic low back pain using larger sample sizes or alternative control groups.
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J Manipulative Physiol Ther · Nov 2003
Meta AnalysisEfficacy of spinal manipulative therapy for low back pain of less than three months' duration.
To review the efficacy of spinal manipulation for low back pain of less than 3 months duration. Data sources Randomized clinical trials on spinal manipulative therapy for low back pain were identified by searching EMBASE, CINAHL, MEDLINE, and the Physiotherapy Evidence Database (PEDro). Study selection Outcome measures of interest were pain, return to work, adverse events, disability, quality of life, and patient satisfaction with therapy. Data extraction Methodological assessment of the trials was performed using the PEDro scale. Trials were grouped according to the type of intervention, outcome measures, and follow-up time. Where there were multiple studies with sufficient homogeneity of interventions, subjects, and outcomes, the results were analyzed in a meta-analysis using a random effects model. Data synthesis Thirty-four papers (27 trials) met the inclusion criteria. Three small studies showed spinal manipulative therapy produces better outcomes than placebo therapy or no treatment for nonspecific low back pain of less than 3 months duration. The effects are, however, small. The findings of individual studies suggest that spinal manipulative therapy also seems to be more effective than massage and short wave therapy. It is not clear if spinal manipulative therapy is more effective than exercise, usual physiotherapy, or medical care in the first 4 weeks of treatment. ⋯ Spinal manipulative therapy produces slightly better outcomes than placebo therapy, no treatment, massage, and short wave therapy for nonspecific low back pain of less than 3 months duration. Spinal manipulative therapy, exercise, usual physiotherapy, and medical care appear to produce similar outcomes in the first 4 weeks of treatment.