Articles: low-back-pain.
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Physical rehabilitation is one of the major forms of treatment of chronic low back pain. The ability of some patients to cooperate is limited by pain. Since 1992 continuous epidural analgesia has been combined with a physical rehabilitation programme for patients with chronic low back pain who have been unable to make progress with conventional physical rehabilitation due to severity of pain. ⋯ Continuous 5 day epidural analgesia combined with intensive physiotherapy may offer a means of initial rehabilitation of chronic low back pain. The initial benefit was most marked at 1 week, with benefit still evident after 1 month. However, the benefit decreased with time. This technique may be of value as part of a more comprehensive programme of physical and psychological rehabilitation.
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J. Clin. Gastroenterol. · Apr 1998
Letter Case ReportsPseudomembranous colitis induced by diclofenac.
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Randomized Controlled Trial Clinical Trial
A fitness programme for patients with chronic low back pain: 2-year follow-up of a randomised controlled trial.
The aim of this study was to assess the long-term effect of a supervised fitness programme on patients with chronic low back pain. The design of the study was a single blind randomised controlled trial with follow-up, by postal questionnaire, 2 years after intervention. The Oswestry Low Back Pain Disability Index was used as the outcome measure to assess daily activity affected by back pain. ⋯ Between group comparisons demonstrated a statistically significant difference in disability scores between the treatment and control group (mean difference 5.8, 95% confidence interval 0.3, 11.4 P < 0.04). This study supports the current trend towards a more active treatment approach to low back pain. We have demonstrated clinical effectiveness of a fitness programme 2 years after treatment but this needs to be replicated in a larger study which should include a cost effectiveness analysis, further analysis of objective functional status and a placebo intervention group.
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Int J Qual Health Care · Apr 1998
Understanding physicians' imaging test use in low back pain care: the role of focus groups.
To gain understanding about why a controlled intervention to reduce variability in lumbar spine imaging test use rates for low back pain patients was ineffective among internal medicine and family practice physicians in a large US health maintenance organization. ⋯ Our findings suggest that gaining information from focus groups prior to designing physician behavior change interventions may aid the design of more effective interventions.
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There is little evidence about the management and course of chronic low back pain in primary care. ⋯ A variety of options for the treatment and referral of chronic low back pain patients is available for and used by GPs. Efforts should be made to establish which diagnostic and therapeutic procedures are the most effective for chronic low back pain.