Articles: low-back-pain.
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J Manipulative Physiol Ther · Jan 2002
Randomized Controlled Trial Clinical TrialThe reliability of multitest regimens with sacroiliac pain provocation tests.
Studies concerning the reliability of individual sacroiliac tests have inconsistent results. It has been suggested that the use of a test regimen is a more reliable form of diagnosis than individually performed tests. ⋯ A multitest regimen of 5 sacroiliac joint pain provocation tests is a reliable method to evaluate sacroiliac joint dysfunction, although further study is needed to assess the validity of this test method.
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Stud Health Technol Inform · Jan 2002
The significance of correlation of radiographic variables and MOS short-form health survey for clinical decision in symptomatic low back pain patients.
To assess any correlation between SF-36 scores and several lateral roentgenographic variables of the lumbar spine, both in low back pain patients and asymptomatic volunteers. The clinical relevance of the method proposed in this study to make a surgical strategy on the basis of distinct lateral roentgenographic parameters and conversely was assessed by independent radiologists and physicians. ⋯ SF-36 scores were correlated with distinct lateral roentgenographic variables of the lowermost lumbar spine (L4-S1) in low back patients, and of the whole lumbar spine in asymptomatic individuals. Clinical decision should not be taken on the basis of radiological evidence of pathology because clinical decision seems to be more accurate when is taken on the basis of combined SF-36 and roentgenographic data. However, clinical examination is mandatory to SF-36 questionnaire and radiographic analysis.
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Chronic low back pain secondary to involvement of the facet joints is a common problem. Facet joints have been recognized as potential sources of back pain since 1911. Multiple authors have described distributions of pain patterns of facet joint pain. ⋯ Multiple studies utilizing controlled diagnostic blocks have established the prevalence of lumbar facet joint involvement in patients with chronic low back pain, as ranging from 15% to 52%, based on type of population and setting studied. Long-term therapeutic benefit has been reported from three types of interventions in managing lumbar facet joint pain, including intraarticular injections, medial branch blocks and neurolysis of medial branches. This review will discuss chronic low back of facet joint origin and covers anatomy, pathophysiology, diagnosis, and various aspects related to treatment, including clinical effectiveness, cost effectiveness, technical aspects and complications.
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Cochrane Db Syst Rev · Jan 2002
ReviewAdvice to stay active as a single treatment for low back pain and sciatica.
Low back pain is one of the most common conditions managed in primary care. Restricted activity, rest, and symptomatic analgesics are the most commonly prescribed treatment for low back pain and sciatica. ⋯ The best available evidence suggests that advice to stay active alone has small beneficial effects for patients with acute simple low back pain, and little or no effect for patients with sciatica. There is no evidence that advice to stay active is harmful for either acute low back pain or sciatica. If there is no major difference between advice to stay active and advice to rest in bed, and there is potential harmful effects of prolonged bed rest, then it is reasonable to advise people with acute low back pain and sciatica to stay active. These conclusions are based on single trials.
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A systematic review of randomised clinical trials was conducted to assess the effect of spinal manipulative therapy on clinically relevant outcomes in patients with chronic low back pain. Databases searched included EMBASE, CINAHL, MEDLINE and PEDro. Methodological assessment of the trials was performed using the PEDro scale. ⋯ Spinal manipulative therapy reduced disability by 6 points (95% CI 1 to 12) on a 100-point disability questionnaire when compared with NSAIDs. It is concluded that spinal manipulation does not produce clinically worthwhile decreases in pain compared with sham treatment, and does not produce clinically worthwhile reductions in disability compared with NSAIDs for patients with chronic low back pain. It is not clear whether spinal manipulation is more effective than NSAIDs in reducing pain of patients with chronic low back pain.