Articles: low-back-pain.
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Sacral insufficiency fractures are an often unsuspected cause of low-back pain in elderly women with osteopenia who have sustained unknown or only minimal trauma. The authors describe 10 cases of spontaneous sacral insufficiency fractures, confirmed by computed tomography, characterized by the onset of acute low-back pain. Differential clinical and radiographic diagnosis of these fractures is often difficult. ⋯ The fractures extend vertically in the sacral alae, parallel to the sacroiliac joints. They are located just lateral to the margins of the lumbar spine. This distribution suggests that such fractures could be partially caused by weight-bearing transmitted through the spine.
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The purpose of our study was to investigate whether Minnesota Multiphasic Personality Inventory-2 cluster solutions of chronic low-back pain patients would replicate those found in previous research with the Minnesota Multiphasic Personality Inventory. ⋯ These findings indicate that interpretations of the Minnesota Multiphasic Personality Inventory-2 should parallel those of the Minnesota Multiphasic Personality Inventory for chronic low-back pain patients. They further suggest that the results of Minnesota Multiphasic Personality Inventory-based studies are also applicable to Minnesota Multiphasic Personality Inventory-2.
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Three patients with diabetic radiculopathy (DR) are presented. The clinical aspects of DR, its management, and differential diagnosis are reviewed. Diabetic radiculopathy commonly presents with severe unilateral pain of sudden onset that is usually located in the lower extremity, frequently in the proximal segments. ⋯ Weakness of hip or thigh muscles, decreased sensation and hypo- or areflexia are commonly observed. The clinical picture can resemble that of high lumbar disc herniation. Electrodiagnostic and radiological studies may help differentiate between the two conditions.
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Review Comparative Study
Do antidepressant medications relieve chronic low back pain?
Antidepressant medications are commonly prescribed for patients with chronic low back pain. A literature synthesis was performed to determine whether antidepressants are more effective than placebos in decreasing pain, disability, depression, and analgesic medication use in such patients. ⋯ The literature has not demonstrated that antidepressants are superior to placebos in improving low back pain or related problems. However, further randomized controlled trials are needed to determine whether antidepressants are useful for low back pain.
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The facet syndrome seems to be a common cause of low back pain. Percutaneous radiofrequency lumbar facet denervation, developed by Shealy, may be of therapeutic value in facet syndrome patients. This method consists in thermocoagulation of the middle branch of the dorsal primary ramus of the spinal nerve. ⋯ Success rates reported in the literature vary widely, from 14% to 76%. Interpretation of these data is difficult since studies used a broad range of treatment techniques, evaluation methods, and patient selection criteria. A prospective study using stringent inclusion criteria and appropriate evaluation criteria taking quality of life into account is needed to determine the role of percutaneous facet denervation among other treatment options available to low back pain patients.