Articles: low-back-pain.
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Despite ongoing clinical suspicion regarding the relationship between sacroiliac joint (SIJ) dysfunction and lower extremity symptoms, there is a paucity of scientific literature addressing this topic. The purpose of this study was to describe patterns of contrast extravasation during SIJ arthrography and postarthrography CT in patients with lower back pain and to determine whether there are pathways of communication between the SIJ and nearby neural structures. ⋯ Three pathways between the SIJ and neural structures exist.
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Comparative Study
Medical versus surgical treatment for low back pain: evidence and clinical practice.
Although low back pain is one of the most common health problems, it is still difficult to choose between surgical and medical treatment. ⋯ The literature comparing the efficacy of surgical and medical treatment for low back pain is limited. Not surprisingly, the use of surgery for low back pain varies widely across the United States. To establish clinical consensus, we need better evidence about the efficacy of surgery.
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This experiment was set up to test the hypothesis that confrontation with feared movements would lead to symptom-specific muscular reactivity in chronic low back pain patients who report high fear of movement/(re)injury. Thirty-one chronic low back pain patients were asked to watch a neutral nature documentary, followed by a fear-eliciting video-presentation, while surface electromyography (EMG) recordings were made from the lower paraspinal and the tibialis anterior muscles. It was further hypothesized that negative affectivity (NA) would moderate the effects of fear on symptom-specific muscular reactivity, as well as the effects of muscular reactivity on pain report. ⋯ As predicted, there was a significant covariation between left paralumbar muscular activity and pain report. This association was moderated by NA, but in the opposite direction. The findings extend the symptom-specificity model of psychophysiological reactivity, and support the idea that pain-related fear perpetuates pain and pain disability through muscular reactivity.
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The prevalence of low back pain in the older population (> = or 65 years) was reviewed in an analysis of the literature from 1966 to the present. ⋯ There is an under-representation of the older population in the back pain literature. The data in the current study suggest that the prevalence of low back pain in this population is not known with certainty and is not comparable with that in the younger population. The authors stress the need for future studies to improve the reporting of age information to make prevalence studies more informative and applicable.
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An observational study of the relation between disability and psychological distress in patients with no on-going compensation claim who underwent posterior lumbar interbody fusion for chronic low back pain. ⋯ Postoperative improvement in disability was not found to be related to preoperative psychology as measured by the Distress and Risk Assessment Method score. Change in disability is significantly related to change in distress.