Articles: low-back-pain.
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Int J Clin Exp Hypn · Jan 1998
Hypnotic analgesia: 1. Somatosensory event-related potential changes to noxious stimuli and 2. Transfer learning to reduce chronic low back pain.
Fifteen adults with chronic low back pain (M = 4 years), age 18 to 43 years (M = 29 years), participated. All but one were moderately to highly hypnotizable (M = 7.87; modified 11-point Stanford Hypnotic Susceptibility Scale, Form C [Weitzenhoffer & Hilgard, 1962]), and significantly reduced pain perception following hypnotic analgesia instructions during cold-pressor pain training. In Part 1, somatosensory event-related potential correlates of noxious electrical stimulation were evaluated during attend and hypnotic analgesia (HA) conditions at anterior frontal (Fp1, Fp2), midfrontal (F3, F4), central (C3, C4), and parietal (P3, P4) regions. ⋯ Over three experimental sessions, participants reported chronic pain reduction, increased psychological well-being, and increased sleep quality. The development of "neurosignatures of pain" can influence subsequent pain experiences (Coderre, Katz, Vaccarino, & Melzack, 1993; Melzack, 1993) and may be expanded in size and easily reactivated (Flor & Birbaumer, 1994; Melzack, 1991, 1993). Therefore, hypnosis and other psychological interventions need to be introduced early as adjuncts in medical treatments for onset pain before the development of chronic pain.
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McKenzie methods stress self-treatment through correct posture and repeated end-range movements performed at a high frequency. Dr. Simonsen describes the basic principles and outlines the three syndromes and specific treatment protocols identified by McKenzie.
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Commonly prescribed drugs for the treatment of low back pain have varying success rates, costs, and complications. This chapter presents current information on acetaminophen, nonsteroidal anti-inflammatory agents, muscle relaxants, opioids, corticosteroids, antidepressants, and colchicine to help the physician in determining a pharmacologic strategy.
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Lumbar spine injections have a role in the evaluation and treatment of low back pain. These injection procedures have been demonstrated to be effective in determining whether certain structures are responsible for low back pain. There is still debate as to the long-term pain relief from epidural and intra-articular facet joint injections, and there are no controlled studies examining the long-term effects of SI joint injections. ⋯ This duration of pain relief creates an opportunity to maximize rehabilitation efforts while symptoms are minimal. There is a need for more controlled studies to evaluate the long-term effectiveness that these lumbar spine injections have on controlling low back pain. Future studies also need to assess in a controlled manner the impact that these injections have no rehabilitation and their role in functional restoration of lumbar spine disorders.