Articles: low-back-pain.
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J Manipulative Physiol Ther · Jun 2000
Chiropractic management of mechanical neck and low-back pain: a retrospective, outcome-based analysis.
Evidence suggests that spinal manipulation is an effective treatment for mechanical neck and low-back pain (LBP). Treatment efficacy is important to establish for these symptoms because combined they account for a considerable amount of disability and substantial associated direct and indirect costs to society. ⋯ Patients attending a private chiropractic clinic for treatment of mechanical neck pain or LBP had statistically significant reductions in their pain-related disability after treatment. These results indicate that chiropractic manipulation is beneficial for the treatment of mechanical neck pain and LBP. However, care must be taken when drawing conclusions from these outcomes. The study design does not account for the natural history of low back- or neck pain-related disability and therefore does not allow for claims of treatment efficacy. In addition, it has been suggested that patients presenting to medical doctors with these symptoms have significant overlying comorbidity when compared with patients presenting to a chiropractor.
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Failed back surgery syndrome (FBSS) is an important complication of lumbar disc surgery. Epidural fibrosis is one of the major causes of FBSS. However, most patients with epidural fibrosis do not develop symptomatic complaints from scarring. ⋯ Moreover, postoperative VAS scores were positively correlated with the scores of the mini MMPI. These findings indicate that epidural fibrosis may be considered as a radiological entity independent of patients' complaints. Furthermore, the mini MMPI should be included in the assessment and planning of the reoperations in FBSS patients, because of the importance of psychological factors in postoperative pain and disability.
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J Manipulative Physiol Ther · Jun 2000
Clinical TrialSilver needle therapy for intractable low-back pain at tender point after removal of nucleus pulposus.
To examine the use of a new silver needle therapy for treating tender points involved in intractable low-back pain after removal of nucleus pulposus. ⋯ Silver needle therapy shows promise for treating low-back pain after surgery for disc herniation. Further clinical trials are needed to confirm the effectiveness of this treatment.
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J Manipulative Physiol Ther · Jun 2000
Clinical Trial Controlled Clinical TrialShort-term effects of lumbar posteroanterior mobilization in individuals with low-back pain.
To establish the short-term effects of lumbar posteroanterior mobilization in patients with low-back pain, compared with a control intervention. ⋯ Lumbar posteroanterior mobilization was not observed to produce any objectively measurable change in the mechanical behavior of the lumbar spine of patients with low-back pain. Improvement in some pain variables was observed in comparison with a control procedure, but this may be due to a placebo effect.
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Comparative Study
The relationship of disability (Oswestry) and pain drawings to functional testing.
There was much enthusiasm about the development of computerized dynamometry in providing large quantities of data to objectively assess muscle performance. However, a much more basic issue arose questioning what these machines actual measure, particularly in pain populations. The purpose of the present study was to determine whether patients' self-reported disability and pain expression, as evaluated with simple questionnaires, were related to isokinetic performance in low back pain patients. ⋯ The results of this study indicate that isokinetic test values are significantly influenced by a patient's self-reported disability and pain expression, which can be evaluated using simple tools such as pain drawings and the Oswestry questionnaire. This study supports the supposition that dynamometry testing is related to factors other than muscle performance.