Articles: low-back-pain.
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Clinical Trial Controlled Clinical Trial
Lumbar paraspinal muscle function, perception of lumbar position, and postural control in disc herniation-related back pain.
A follow-up study evaluating postural control, lumbar movement perception, and paraspinal muscle reflexes in disc herniation-related chronic low back pain (LBP) before and after discectomy. ⋯ The results demonstrate impaired lumbar proprioception and postural control in sciatica patients. During short-term follow-up after operative treatment, postural control does not seem to change, but impaired lumbar proprioception and feed-forward control of paraspinal muscles seem to recover.
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A reliability study was performed. ⋯ The ODI was highly reliable. The questions about work, back satisfaction, and pain medication showed good agreement. The GFS, pain intensity, fear-avoidance beliefs, and life satisfaction appeared to lack sufficient reliability to be recommended in postal questionnaires.
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Reliability and ease of use of the Itrel 3 System (Medtronic Inc., Minneapolis, MN) were prospectively assessed over 5 years in patients with a range of pain syndromes (mainly low back and/or leg pain, or ischemic pain due to peripheral vascular disease). The longevity of the implantable pulse generator (IPG) battery, the frequency with which system settings were changed, and the ease of use of the EZ patient programmer were assessed. Data on adverse events, pain relief, and patient satisfaction with therapy were also collected. ⋯ The intensity and duration of pain were reduced significantly and patient satisfaction with therapy was high. We conclude that the Itrel 3 System performed well over 5 years and was easy to use. Its safety and effectiveness for the relief of chronic intractable pain of the trunk or limbs were also confirmed.
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It is widely believed that the extent of a patient's subjective complaints are often based on developmental, psychological, social, and cultural factors rather than structural or physical pathology. In patients presenting with chronic low back pain, underlying behavioral problems may not be immediately apparent. These behavioral or non-physiological issues may be secondary to a deliberate deception or may be associated with psychological distress. ⋯ Results showed that 27 patients (22%) presented with non-physiological symptoms, 34 patients (28%) with non-physiological signs, and 19 patients (16%) with combined presence of non-physiological signs and symptoms. Overall there was significant correlation of non-physiological signs with depression, anxiety, and somatization, both by diagnosis of depression, diagnosis of anxiety and elevated scores. However, correlation was present for non-physiological symptoms only with elevated scores of anxiety and somatization.
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The purpose of this current opinion on sacroiliac joint pain and dysfunction is to assist interventional pain physicians to apply appropriate treatment decisions and rationale to their patients in pain. Discussion of relevant scientific data and controversial positions will be provided. ⋯ Discussion will provoke support or criticism of the relevant scientific data, and general recommendations for interventional pain management physicians should be considered within the context of the individual practitioners skill and practice patterns. Current Opinion is not intended to provide a standard of care.