Articles: low-back-pain.
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In Physical Medicine and Rehabilitation structural and functional disorders in the genesis of back pain are of great importance. From an epidemiological point of view this has great consequences. Active and passive forms of physical therapy are available. ⋯ Sometimes a combination of active and passive forms are of benefit. Every treatment concept has to pay regard to the actuality of pain, the load of every day life and the physical and social situation of the patient. Last but not least one has to learn to cope with the pain.
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Review Comparative Study
Sacro-iliac joint pain: etiology and conservative treatment.
Orthopedic surgeons use many modalities in conservative treatment of low back pain (LBP) and sacroiliac pain (SIP) but few have been studied with randomized controlled trials. We have been studying the physiological effects of manipulation on joints and the clinical effect on patients. ⋯ The iliac and sacral surfaces of the sacroiliac joint develop differently. Although this statement need further study it seems that manipulations may play a role in the treatment of LBP and SIP.
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We have reviewed our experience with spinal cord stimulation (SCS) in patients with low back and leg pain. 33 patients complaining of leg and low back pain underwent percutaneous tests of SCS. 28 patients had failed back surgery syndromes, 1 patient had pain related to an L1 vertebral body fracture, another from Tarlow cysts and the remaining 3 patients had lumbosacral spondyloarthrosis and osteoporosis without radiological signs of root compression. 28 patients showed mono- or pluriradicular deficits. At the end of the test period (5-65 days), 21 patients (63.6%) reported more than 50% of pain relief (mean analgesia 75%) and were submitted to chronic stimulation. The mean follow-up was 45.5 months. At maximum available follow-up, 40% of the patients (13 out of the 33 initial patients) were successfully using the stimulator (mean analgesia 66.6%).
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Arthritis and rheumatism · Jan 1994
Physician variation in diagnostic testing for low back pain. Who you see is what you get.
This study examined patterns of diagnostic test use for patients with low back pain. Three specific questions were addressed: 1) What tests do physicians recommend for patients with 3 common types of low back pain? 2) Do physicians in various specialties differ in the tests they would order? and 3) How appropriate are physicians' choices of tests, based on current medical knowledge and expert recommendations? ⋯ There is little consensus, either within or among specialties, on the use of diagnostic tests for patients with back pain. Thus, the diagnostic evaluation depends heavily on the individual physician and his or her specialty, and not just the patient's symptoms and findings. Furthermore, many physicians may be ordering imaging studies too early and for patients who do not have the appropriate clinical indications. These results suggest a need for additional clinical guidelines as well as better adherence to existing guidelines.