Articles: low-back-pain.
-
J Bone Joint Surg Br · Jul 1996
The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration.
The afferent pathways of discogenic low-back pain have not been fully investigated. We hypothesised that this pain was transmitted mainly by sympathetic afferent fibres in the L2 nerve root, and in 33 patients we used selective local anaesthesia of this nerve. Low-back pain disappeared or significantly decreased in all patients after the injection. ⋯ Our findings show that the main afferent pathways of pain from the lower intervertebral discs are through the L2 spinal nerve root, presumably via sympathetic afferents from the sinuvertebral nerves. Discogenic low-back pain should be regarded as a visceral pain in respect of its neural pathways. Infiltration of the L2 nerve is a useful diagnostic test and also has some therapeutic value.
-
A prospective blind study compared three new technologies to assess back pain. ⋯ The diagnostic accuracy of thermography in recent onset low back pain does not support its use. Among those simulating normality or low back pain, triaxial dynamometry and spinoscopy have greater diagnostic accuracy than does a single clinical evaluation. However, for an individual, the inaccuracy that remains limits the use of triaxial dynamometry or spinoscopy for diagnosis in recent onset low back pain.
-
J Epidemiol Community Health · Jun 1996
Prevalence of low back pain in the community: implications for service provision in Bradford, UK.
To assist a purchasing district in the planning of services for low back pain by assessing the prevalence of symptoms and the current involvement of primary, secondary, and complementary care in the treatment of low back pain. In the light of these findings, to assess further the potential impact of a new system of open access to physical therapy, as recommended by the British Clinical Standards Advisory Group (CSAG). ⋯ Local prevalence estimates may allow purchasers to estimate the potential effects of a shift in management policy for low back pain and to highlight areas of unmet need in terms of resources and patient education.
-
Two hundred and eight patients of low back pain were studied in the department of orthopaedic surgery, GSVM Medical College, Kanpur. The patients were put on intensive conservative treatment in the form of analgesics, hard bed rest, spinal extension exercises, traction and lumbosacral support. Thirty-two patients did not respond to this treatment and their symptoms were of more than 6 months duration and they were subjected to epidural injection of local anaesthetic agent, saline and corticosteroids. ⋯ The aim of this study is to develop standardised strategy for the treatment of low back pain. For the low back pain patients not responding to intensive conservative treatment, an idea has been put forward in the form of epidural medication prior to considering them to surgery to prevent unnecessary incidence of "failed back". A trial of epidural injection is suggested to avoid surgery.
-
Minim Invas Neurosur · Jun 1996
Short test-period spinal cord stimulation for failed back surgery syndrome.
The aim of this study was to investigate the effects of spinal cord stimulation (SCS) on patients with chronic pain due to failed back surgery syndrome and to evaluate selection criteria for predicting SCS success. Thirty-two patients were enrolled in the present study. Prior to test implantation, all of them have been screened with various plan questionnaires and were selected for the SCS procedure according to stringent criteria. ⋯ Follow-ups of 2 to 3.5 years after lead implantation proved stable analgesia and good outcome in 25 patients. Further 4 patients experienced a late failure of the system due to decreased analgesic effects of SCS. In conclusion, if the selection of SCS candidate patients is performed very carefully and according to well defined criteria, test stimulation periods can be kept relatively short, thus reducing therapeutic failures, risk of infection, and costs of therapy.