Articles: low-back-pain.
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Low back pain (LBP) remains a common and costly problem among the nursing profession. Several studies have indicated that LBP is attributed to mentally straining or demanding work, fatigue or exhaustion or general work satisfaction. ⋯ The results indicate that an association exists between work stress, manual lifting and LBP prevalence. The main route to prevention of LBP among nurses is likely to lie in improved ergonomics and psychological health in their work place. Good posture and correct transferring techniques in ward situations should be reinforced with hands-on practice performed on nurses' common types of clients.
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J Altern Complement Med · Dec 2001
The diagnosis and treatment of patients with chronic low-back pain by traditional Chinese medical acupuncturists.
The selection of appropriate treatments in clinical trials of acupuncture requires understanding how acupuncturists diagnose and treat specific conditions. We examined the Traditional Chinese Medical (TCM) diagnoses and treatments for patients with chronic low-back pain using two separate sets of treatment records. Information from more than 150 initial visits was available for analysis. ⋯ There was substantial variability in treatments among providers. Such diversity will make it challenging to select a single treatment that has wide applicability. We recommend that researchers attempt to develop a treatment that is considered credible by expert acupuncturists and has broad features characteristic of patterns of common clinical practice.
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Jt Comm J Qual Improv · Dec 2001
Implementing guidelines for interdisciplinary care of low back pain: a critical role for pre-appointment management of specialty referrals.
Improving health care will require more effective guideline implementation and redesign of delivery processes and systems. Patient referral for specialty care is a key component of health system function that needs to be improved. Low back pain care is a widely documented example of the need for improvement. An interdisciplinary systemwide back pain program was developed using process improvement methods. Proactively managing referrals for specialty care-a departure from traditional referral processes-played a critical role in implementing the program. ⋯ Pre-appointment referral management offers an approach for improving guideline implementation, access to specialty services, and the effectiveness of care for complex health problems. It deserves broader study and adoption.
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Nuklearmed Nucl Med · Dec 2001
[The insufficiency fracture of the sacrum. An often unrecognized cause of low back pain: results of bone scanning in a major hospital].
The insufficiency fracture of the sacrum is often radiographically occult. Bone scintigraphy is a method of reference for the diagnosis; the results have been analysed retrospectively. ⋯ The insufficiency fracture of the sacrum as cause of lower back pain is not uncommon, especially in postmenopausal women with risk factors. Bone scintigraphy is not only an adequate procedure for the detection of often radiographically occult sacral fractures, but also an easy method to reveal the often concomitant fractures.
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These times of changing paradigms raise the question of the indications for and limits of physical therapy in back pain management. At present, several national and international guidelines for the care of chronic back pain are available. Unfortunately, the guidelines are often inconsistent concerning physiotherapy. ⋯ Considering the ICIDH-2 directives it is not helpful to judge efficacy solely by somatic parameters such as mobility and muscle force. A patient without good mobility could still return to work. A subjective feeling of well being or low disability on the side of the patient is an equally important parameter of successful treatment as the good physical capacity for daily life.