Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial.
A randomized, assessor-blinded clinical trial was conducted. ⋯ For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.
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J Spinal Disord Tech · Jun 2002
Clinical Trial Controlled Clinical TrialDoes provocative discography screening of discogenic back pain improve surgical outcome?
The value of preoperative provocative discography in the setting of discogenic low back pain was investigated by evaluating surgical outcomes. Seventy-three consecutive patients who underwent posterolateral interbody and posterior spinal arthrodesis for discogenic low back pain refractory to nonoperative management were reviewed. Chronologically, the first 41 patients (group A) were indicated without discography, whereas the remaining 32 (group B) had been indicated only if their pain had been reproduced during disc injection. ⋯ Using modified Oswestry scoring, group A and group B patients had satisfactory outcomes of 75.6% and 81.2%, respectively. This difference was neither statistically significant nor suggestive. In this study, provocative discography screening did not improve surgical outcomes after circumferential fusion for lumbar discogenic back pain.
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Arch Phys Med Rehabil · Jun 2002
Comparative StudyThe use of Rasch measurement to improve the Oswestry classification scheme.
To use Rasch measurement to assess and modify the original classification categories of the Oswestry Low Back Pain Disability Questionnaire (Oswestry), to examine the hypothesis that the items from the Oswestry form a unidimensional construct and a hierarchical representation of low back pain (LBP) disability, and to compare ordinal Likert resultant scores to interval Rasch scaled scores with disability categories serving as a framework. ⋯ Rasch analysis produced disability categories in the Oswestry that are linear and, therefore, useful for quantitatively assessing self-reported disability levels.
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Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. ⋯ There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks.
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A committee of health specialists examined the demand characteristics and efficiency of German health care services and published an expertise on the misallocation of services that among other subjects also covered the area of low back pain. Although we agree with their principal statements, we like to underscore that the objectives mentioned in the report cannot be achieved without the participation of psychologists. ⋯ Psychologists investigated these mechanisms, developed interventions for the prevention and treatment of low back pain on the basis of the results, and tested their efficacy in trials with a high methodological standard. Incorporation of psychological expertise does not only optimise prevention and treatment of low back pain and helps to prevent unnecessary suffering of the afflicted, in addition, it offers a contribution a cost containment.