Articles: low-back-pain.
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A cross-sectional study on patients with chronic low back pain to compare relationships between subjective disability and pain intensity, pain duration, pain location, and work-related factors. ⋯ The results suggest that subjective disability in patients with chronic low back pain overlaps with both pain and work-related factors. The observations support the multidimensionality of low back disability.
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A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. ⋯ The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.
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Low back pain ist frequently associated with malposition of the pelvis due to an imbalance of the postural muscles. In these patients functional malposition of both the sacrum and the ileum can be observed, resulting in differences in the length of the legs. We investigated whether the return to a normal position correlated with pain relief. ⋯ Differences in the length of the legs can be successfully treated by manual therapy at C0/C1 or C2/C3 in the majority of patients with pelvic malposition. However, infiltration of the iliosacral joints is often required as additional therapy for short-term and long-term pain relief. Treatment with NSAIDs alone is only seldom effective in cases of pelvic malposition and rarely affords long-term pain relief.