Articles: low-back-pain.
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Pain intensity ratings of 'usual' pain, or pain 'on average', are gaining in popularity since they are arguably a more realistic measure of a patient's pain status than the single snapshot of 'current' pain. An alternative to the 'actual average' of ratings obtained from multiple measures is the single rating of patients' recall of their 'usual' pain over a period of time, usually 1 week. The use of such a scale relies on the assumption that patients can accurately recall their 'usual' pain. ⋯ Using the Intra-class Correlation Coefficient (ICC) to compute accuracy, the single rating asking patients to estimate their pain 'on average' over the week was found to be an accurate measure of 'actual average' pain intensity (ICC=0.82) and more accurate than 'current' pain (ICC=0.66). Although some composite measures of single ratings gave more accurate estimates of 'actual average' pain, this was not considered sufficient advantage to advocate their use. The results of this study propose the single rating of pain 'on average' as a valid and practical measure of a patient's pain intensity over a period of 1 week.
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Randomized Controlled Trial Clinical Trial
Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care.
A double-blind, randomized controlled trial of a novel educational booklet compared with a traditional booklet for patients seeking treatment in primary care for acute or recurrent low back pain. ⋯ This trial shows that carefully selected and presented information and advice about back pain can have a positive effect on patients' beliefs and clinical outcomes, and suggests that a study of clinically important effects in individual patients may provide further insights into the management of low back pain.
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Experimental disc injections in subjects with no history of low back symptoms. ⋯ The findings of this study demonstrate that patients with no history of low back pain who had undergone posterior iliac bone graft harvesting for nonlumbar procedures often experienced a concordant painful sensation on lumbar discography with their usual gluteal area pain. Thus, the ability of a patient to separate spinal from nonspinal sources of pain on discography is questioned, and a response of concordant pain on discography may be less meaningful than often assumed.
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Corticosteroid injections into the spinal epidural space are frequently used to effect a relief of back pain and associated radicular extremity symptoms. Spinal epidural lipomatosis has been documented after the use of systemic corticosteroid therapy. This case report documents the development of epidural lipomatosis after the administration of multiple epidural steroid injections. The development and subsequent resolution after discontinuation of the steroid injections are demonstrated with serial magnetic resonance imaging.
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Comparative Study
In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems.
In vivo intradiscal pressure measurement in different postures in healthy individuals and in those with ongoing back problems. ⋯ The spinal load was highly dependent on the angle of the motion segment in normal discs in vivo. The intradiscal pressure in degenerated discs was significantly reduced compared with that of normal discs. However, further studies on the effect of respiratory movement on intradiscal pressure, the difference between vertical and the horizontal pressures, and the difference in the spinal load between standing and the sitting body positions are necessary. The data obtained from the current study are fundamental to understanding the pathomechanisms and biomechanical problems of disc disease.