Articles: low-back-pain.
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Int J Clin Pharm Th · Apr 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialParenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study.
Two hundred and sixty patients with lumbago or sciatic pain participated in a multicenter observer-blind randomized trial to compare the efficacy and tolerability of dipyrone 2.5 g, diclofenac 75 mg, and placebo administered as an intramuscular injection once daily for the duration of one to two days. The effectiveness of the test treatments in relieving sciatic pain was measured by a visual analog scale (VAS) before and 30 minutes, 1, 2, 3, 6 and 24 hours after each injection. In addition, the patient's general well-being was measured on a 5-point rating scale on day 0, 1 and 2. ⋯ Pain intensity on VAS (primary endpoint) showed a significantly greater reduction with dipyrone than with diclofenac or placebo between 1 and 6 hours after application (p < 0.01) and at the end of the trial (after 48 hours). Improvement in general well-being and minimal finger-toe distance was greatest in the dipyrone group. 59% of the patients with dipyrone assessed the overall efficacy as "excellent" or "very good", compared with 30% with diclofenac, and 18% with placebo. Adverse reactions were reported in only 7 patients (3%), 4 (5%) in the dipyrone, 1 (1%) in the diclofenac, and 2 (2%) in the placebo group.
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A prospective cross-sectional analytic approach was taken. ⋯ In patients with chronic low back pain, the combination of discogenic pain and zygapophyseal joint pain is uncommon.
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J Consult Clin Psychol · Apr 1994
Acute and chronic low back pain: cognitive, affective, and behavioral dimensions.
Despite strong suppositions concerning differences between patients suffering acute and chronic low back pain, relatively few data-based comparisons have been made. In this study, affective, cognitive, behavioral, and demographic contrasts were conducted. ⋯ A relatively stereotyped, spontaneous facial expression of pain was observed in all groups when responding to painful movements during a physical examination. The similarities between acute and chronic incongruent patients have implications for the assessment and treatment of low back pain.
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J Am Osteopath Assoc · Mar 1994
Comparative StudyEffects of adding sacral base leveling to osteopathic manipulative treatment of back pain: a pilot study.
A selected group of patients with sacral base unleveling greater than 2 mm were studied to determine the effects of osteopathic manipulative treatment (OMT) and heel lifting on chronic low-back pain. The McGill-Melzack Pain Questionnaire administered by trained personnel was used to assess the patient's pain before and after treatments. ⋯ Seven patients who had been treated previously with OMT and NSAIDs received heel lifts of graduated thickness until the sacral base was within 2 mm of being level. Attaining a "level" sacral base with heel lifts also provided a statistically significant relief from low-back pain.
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Journal of anesthesia · Mar 1994
Effects of continuous epidural block on motor nerve conduction velocity in patients with lower spine disorders.
Thirty-one patients with severe low back pain were treated by continuous epidural block for 18±3 (mean±SEM) days. Motor nerve conduction velocity (MCV) of the common peroneal nerve was measured before and after the treatment. After the treatment, the visual analogue scale score (VAS) and straight leg-raising (SLR) test were markedly reduced (P<0.01), and MCV was increased significantly (P<0.001). ⋯ A significant correlation (P<0.001) between VAS and MCV was demonstrated after treatment. However, in three patients who showed no reduction in VAS even after the treatment, MCV became significantly (P<0.05) slower in spite of nearly normal SLR test results. These results suggest that epidural block treatment improves not only pain but also MCV, and that two parameters, SLR test and pain intensity, are related closely to the MCV.