Articles: low-back-pain.
-
The purposes of this study were to develop screening tests for four low back pain (LBP) diagnoses based on patient reports concerning the severity of pain in various positions and during activities and then to examine the accuracy of these tests in assigning subjects to one of four LBP diagnostic categories. The accuracy of screening tests is determined by calculating sensitivity and specificity and is well established in epidemiology. ⋯ Although more than half of the subjects with a particular LBP diagnosis tested positive for that diagnosis, approximately two thirds of the subjects who tested positive for each of the diagnoses actually had another diagnosis. Negative tests may be more useful in that between 77% and 94% of the subjects without the diagnosis tested negative. Although patient reports of LBP response to position and activity are not sufficient for diagnosis, they may be useful in ruling out a particular diagnosis.
-
Clinical Trial Controlled Clinical Trial
The clinical significance of behavioral treatment for chronic low back pain: an evaluation of effectiveness.
The clinical effectiveness of behavioral treatment for chronic low back pain (CLBP) was evaluated using an empirical strategy to quantify individual patient change. Patients with CLBP (n = 17) presenting to an outpatient pain clinic were evaluated at baseline and six months posttreatment on variables of pain, disability and distress. Similar patients receiving usual medical care (n = 17) were evaluated on the same outcome measures and time line for purposes of descriptive comparison. ⋯ Forty-seven percent of patients receiving behavioral treatment evidenced clinically significant improvement in at least one of the dimensions of pain, disability and depression associated with CLBP. However, clinically significant improvement across all three measures was rare. These findings are discussed in terms of the viability of behavioral treatment for CLBP, the need to enhance the degree of clinically significant outcome associated with behavioral treatments, and the value of empirical evaluation of clinically significant improvement following treatment interventions.
-
A prospective cohort study on low back pain in consecutive patients in general practice, in which potential prognostic indicators at baseline and at the 1-year follow-up examination were assessed by means of four weekly questionnaires. ⋯ Only a few variables appear to be related to the clinical course of low back pain seen in general practice. In particular, the duration preceding the initial visit and, unexpectedly, receiving physical therapy were both associated with a longer duration of low back pain.
-
Comparative Study
Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men.
The amount of lumbar and hip flexion and the relative contribution within movement during standing forward bending was recorded on a group of asymptomatic men and a group of men with a history of chronic low back pain. ⋯ When assessing the relative motion of the lumbar spine and hips in standing forward flexion, there was measurable difference between asymptomatic men and a group of chronic low back pain patients. In particular, two subgroups of individuals with chronic low back pain appeared; one moved relatively similarly to the asymptomatic group, whereas the other sub-group demonstrated reduced hip mobility. These findings indicate the importance of assessing the lumbar and hip flexion motion in chronic low back pain patients to determine if a movement abnormality is present.
-
Z Orthop Ihre Grenzgeb · Jul 1997
[Ultrasound image of the lumbar spine and the lumbosacral transition. Ultrasound anatomy and possibilities for ultrasonically-controlled facet joint infiltration].
Is sonography helpful in facet joint infiltration of the lumbar spine? ⋯ This method is a secure and economic (extra time 2-4 min.) alternative to clinically guided infiltration. Flouroscopy guided infiltration is needed only in anatomical variations or if strictly intraarticular application is necessary.