Articles: low-back-pain.
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Randomized Controlled Trial Clinical Trial
Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program? A search for demographic, socioeconomic, and physical predictors.
A prospective clinical trial was conducted that involved six groups of patients with chronic low back pain selected from a large cohort (N = 816). ⋯ Different factors can be identified as predictive of outcome in a functional restoration program, but most of these factors were also shown to predict success for shorter control outpatient programs or of no treatment.
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Comparative Study Clinical Trial
Effects of epidural steroid injection on pain due to lumbar spinal stenosis or herniated disks: a prospective study.
To describe the extent of pain relief two weeks after an epidural steroid injection in patients with herniated disks and lumbar spinal stenosis, and to identify predictors of changes in pain ratings in each population. ⋯ LSS patients have worse response to ESIs than HD patients. The poor response to ESI in patients with LSS underscores the need for randomized controlled trials of ESI in this population.
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To examine whether psychosocial risks for low back pain, reported in previous studies, are specific to the working population or are more widely relevant. ⋯ Psychosocial factors pose similar risks for a new low back pain episode in workers and the non-employed. This suggests that such influences may not be related solely to work but be a function of general aspects of life. The economic and individual impact of psychosocial interventions in the workplace, therefore, are likely to be limited unless account is taken of the influence of broader non-work related aspects.
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The inability to predict outcome in patients with low back/neck pain leads to inappropriate or unnecessary treatment. The aims of the study were to identify prognostic factors for disability at 1-year follow-up in patients with back pain visiting primary care, and to compare the effect of these in two treatment strategies--chiropractic and physiotherapy. Data were taken from a randomised trial on patients with back/neck pain visiting the general practitioner, in which patients were allocated to chiropractic and physiotherapy as primary management. ⋯ Twelve per cent of the patients had poor prognostic factors (duration > or = 1 month, more than one localisation, low expectations of treatment and low well-being) at entry. These patients had a mean Oswestry score above 20% at 1-year follow-up. Clinical decision models for the management of patients with back pain visiting primary care that consider prognostic factors need to be implemented and prospectively evaluated.