Articles: low-back-pain.
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Review Comparative Study
Guidelines for clinical studies assessing the efficacy of drugs for the management of acute low back pain.
In this paper we propose guidelines for clinical trials aimed at assessing the efficacy of drugs for acute non-specific low back pain (LBP) with or without radicular pain, preliminary to their approval and registration. To this end, consensus statements were obtained from a group of experts in the fields of rheumatology, clinical medicine, public health and epidemiology. EBM resources were systematically used as references. ⋯ Adverse events (AE) should be monitored systematically using a methodology that reflects the mode of action of the tested drug. With the application of these guidelines, LBP could serve as an appropriate disease for testing analgesic drugs. Rigorous evaluation may also help to improve the management of acute LBP.
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Comparative Study
Presurgical biopsychosocial variables predict medical and compensation costs of lumbar fusion in Utah workers' compensation patients.
Elective lumbar fusion surgery is a prevalent and costly procedure that requires a lengthy rehabilitation. It is important to identify presurgical biopsychosocial predictors of medical and compensation costs in such patients. ⋯ Compensation and medical costs associated with posterolateral lumbar fusion can be predicted by preintervention biopsychosocial variables. Cost reduction programs might benefit from identifying biopsychosocial factors related to increased costs.
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Comparative Study
Correlation of clinical examination characteristics with three sources of chronic low back pain.
Research has demonstrated some progress in using a clinical examination to predict discogenic or sacroiliac (SI) joint sources of pain. No clear predictors of symptomatic lumbar zygapophysial joints have yet been demonstrated. ⋯ Significant correlations exist between clinical examination findings and symptomatic lumbar discs, zygapophysial and SI joints. The strongest relationships were seen between SI joint pain and three or more positive pain provocation tests, centralization of pain for symptomatic discs and absence of pain when rising from sitting for symptomatic lumbar zygapophysial joints.
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The objective of this study was to adapt the concept of 'episode-free day', a metric for measuring symptom relief in daily units, to the clinical outcome literature for persistent pain. The episode-free day metric is widely used in other medical literature, but no analogous measure exists in pain literature. Prior focus groups with this population suggested that a 'Day of Manageable Pain Control' was an appropriate name for the metric. ⋯ For both patient samples, '5' was the cut-point that optimally distinguished groups on pain-related interference. '5-8' and '5-7' were double cut-point solutions that optimally divided LBP and OA samples into three categories (e.g. lowest, medium and highest average pain), respectively. Derived cut-points were confirmed using a variety of measures of functional disability. Together with research that showed that average pain ratings of approximately 5 and below permit increased function and quality of life in patients with moderate to severe low back pain and osteoarthritis, our findings provide support for the use of 0-5 on a 0-10 numeric average pain severity scale as one possible criterion for a Manageable Day.
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Bosn J Basic Med Sci · Nov 2003
The effects of McKenzie exercises for patients with low back pain, our experience.
To investigate influence of McKenzie exercises on decreasing the pain in patients with low back pain, to show occurrence of Centralization sign, as a predictor of good treatment outcomes and to evaluate use of McKenzie exercises, as a routine method for lower back pain in Physical Medicine and Rehabilitation Centres. ⋯ McKenzie exercises for low back pain are beneficial treatment for increasing flexibility of spine and improving the pain with better results in pain relief. Although done by minimally trained physiotherapists in McKenzie approach, McKenzie exercises are successful method for decreasing and centralising the pain and increasing spinal movements in patients with low back pain.