Articles: low-back-pain.
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Bupivacaine is a long-acting amide local anesthetic that was introduced to clinical practice in the early 1980s. Since then it has been extensively used for both peripheral blocks as well as neuraxial blockade in concentrations varying from 0.125% to 0.75%. Despite the relatively narrow safety margin, bupivacaine has become the most frequently used local anesthetic in obstetric anesthesia. ⋯ Several studies have failed to show TNS after spinal anesthesia using bupivacaine 0.5% or 0.75%. In the literature there is only 1 case report of TNS after spinal anesthesia using bupivacaine and morphine. The following report describes a case of TNS following spinal anesthesia with bupivacaine 0.75%.
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Comparative Study
A population-based study of factors associated with combinations of active and passive coping with neck and low back pain.
Pain coping strategies can be active or passive. Previous studies have examined these strategies separately, however individuals use combinations of both types of coping strategies. We examined the associations between sociodemographic, pain and health-related factors and combinations of active and passive strategies in a general population random sample of 1,131 adults. ⋯ Lower education was associated with the combination of low levels of active and high levels of passive coping. Individuals with better self-reported general health were less likely to use high levels of passive coping regardless of their active coping. We conclude that high levels of passive coping are strongly associated with disabling pain and that there is no evidence of an association between pain severity and active coping.
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Randomized Controlled Trial Clinical Trial
Acupuncture treatment of chronic low-back pain -- a randomized, blinded, placebo-controlled trial with 9-month follow-up.
There is some evidence for the efficacy of acupuncture in chronic low-back pain (LBP), but it remains unclear whether acupuncture is superior to placebo. In a randomized, blinded, placebo-controlled trial, we evaluated the effect of traditional acupuncture in chronic LBP. A total of 131 consecutive out-patients of the Department of Orthopaedics, University Goettingen, Germany, (age=48.1 years, 58.5% female, duration of pain: 9.6 years) with non-radiating LBP for at least 6 months and a normal neurological examination were randomized to one of three groups over 12 weeks. ⋯ At 9-month follow-up, the superiority of acupuncture compared to the control condition became less and acupuncture was not different to sham-acupuncture. We found a significant improvement by traditional acupuncture in chronic LBP compared to routine care (physiotherapy) but not compared to sham-acupuncture. The trial demonstrated a placebo effect of traditional acupuncture in chronic LBP.
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Meralgia paresthetica is a syndrome of pain or dysesthesia or both in the anterolateral thigh, caused by entrapment of the lateral femoral cutaneous nerve at the anterior superior iliac spine. The aim of this report is to emphasize that meralgia paresthetica can be confused with low-back pain. ⋯ It is important to be rigorous in investigating the etiology of low-back pain. Meralgia paresthetica can mimic low-back pain because of the similarity of the symptoms. It can be treated by conservative or ablative therapeutic interventions; however, conservative methods should be considered primarily.
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Validation of a translated, culturally adapted questionnaire. ⋯ The Spanish version of the RMQ has good comprehensibility, internal consistency, and reliability, and is an adequate and useful instrument for the assessment of disability caused by LBP.