Articles: low-back-pain.
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Confusion surrounding low back pain syndrome may partially be resolved in a select small group of patients by instituting a provocative intraarticular injection of a combination of a local anesthetic and a steroid. This approach enables one to determine whether the sacroiliac joint (SIJ) is the site of origin of the low back pain syndrome. We carried out a study of 71 computed tomography (CT)-guided injections in 58 patients with noninflammatory etiology. ⋯ The effect wore off in 2-14 days in 90% of the patients. We conclude that CT guidance is the best method of precise needle placement, and thus CT-guided anesthetic injection is the most specific confirmatory test for diagnosing the SIJ arthritis. In addition, in noninflammatory conditions, the role of intraarticular injection is primarily for diagnostic purposes and it has little or no therapeutic benefit.
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Randomized Controlled Trial Clinical Trial
The effect of a Mensendieck exercise program as secondary prophylaxis for recurrent low back pain. A randomized, controlled trial with 12-month follow-up.
A prospective, randomized, controlled trial with a stratification block design in which a Mensendieck exercise program was compared with the experience of a control group. ⋯ A secondary prophylaxis Mensendieck exercise program of 20 group sessions significantly reduced the incidence of low back pain recurrences in a population with history of the condition. However, there were no differences between the groups with regard to days of sick leave, low back pain, and function.
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A 15-year follow-up study. ⋯ Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.
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Randomized Controlled Trial Clinical Trial
Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting.
A randomized trial designed to compare interferential therapy with motorized lumbar traction and massage management for low back pain in a primary care setting. ⋯ This study shows a progressive fall in Oswestry Disability Index and pain visual analog scale scores in patients with low back pain treated with either-interferential therapy or motorized lumbar traction and massage. There was no difference in the improvement between the two groups at the end of treatment. Although there is evidence from several trials that traction alone is ineffective in the management of low back pain, this study could not exclude some effect from the concomitant massage.