Articles: low-back-pain.
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We report a case of a patient with metastatic testicular cancer and intractable pain refractory to massive doses of oral, intravenous, and intrathecal (IT) opioids supported by analgesic adjuvants. During our efforts to control his pain, the patient exhibited opioid-induced hyperalgesia, an uncommon but important phenomenon seen with high-dose opioid therapy. With appropriate opioid adjustment--in this case reduction of intrathecal morphine dosage by a factor of 100--the condition rapidly resolved and the patient became pain-free and remained so until his death six weeks later. The keys to identifying this uncommon, but treatable, opioid side effect are recognizing it as a possibility when aggressive efforts to control pain with high doses of opioids, especially when administered neuraxially, are met with increasing pain.
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Case report. ⋯ High intensity zones developed on axial loaded magnetic resonance imaging of the lumbar spine. We postulate that lumbar spine magnetic resonance imaging with axial loading may increase the sensitivity of magnetic resonance imaging for the detection of high intensity zones.
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We conducted a questionnaire study on low back pain (LBP) and working conditions among male taxi drivers employed in the company in Fukuoka city in order to investigate the occurrence of LBP and occupational factors related to LBP among taxi drivers. The study was undertaken through two questionnaires, the first conducted in 1999 (n = 280, first cross-sectional study), the second conducted in 2001 (n = 284, second cross-sectional study). The questionnaire results were used to conduct two analyses: 1) the one-year prevalence of LBP and the relationship between LBP and occupational factors in the second cross-sectional study, and 2) the incidence of LBP and the relationship between LBP and occupational factors from the first to the second cross-sectional study in the longitudinal study. ⋯ The findings of this study also suggest that ergonomic problems with the driver's seat pan, whole-body vibration (WBV) and job stress may contribute to LBP among taxi drivers. Further study is needed to confirm how total mileage contributes to LBP. Furthermore, WBV during normal use of taxies should be measured in order to evaluate the association between WBV and LBP.
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Randomized Controlled Trial Comparative Study Clinical Trial
Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study.
A randomized clinical trial. ⋯ For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years.