Articles: low-back-pain.
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Comparative Study
Successful treatment of low back pain and neck pain after a motor vehicle accident despite litigation.
This prospective study evaluated 39 consecutive patients with low back pain (LBP) or neck pain that resulted from a motor vehicle accident who had litigation pending. ⋯ Patients with low back pain or neck pain resulting from a motor vehicle accident showed a statistically significant improvement with treatment despite ongoing litigation.
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The authors hypothesized that the source of coccygodynia was a lesion of the coccygeal disc. ⋯ Common coccygeal pain could come from the coccygeal disc in approximately 70% of cases.
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Review
[Treatment of chronic lumbago and radicular pain by spinal cord stimulation. Long-term results].
Seventy-seven patients with chronic, refractory, low back and radicular pain underwent implantation of a spinal cord stimulator between 1984 and 1992. Most patients had failed back surgery syndrome. In every case, an epidural quadripolar "Resume" electrode was implanted surgically. ⋯ Adverse events included one case of meningitis, two cases of local infection, and one case each of cerebrospinal fluid fistula and necrosis of the skin overlying the stimulator. The main causes of treatment failure were complications, inappropriate patient selection, and the escape phenomenon. The results of this study demonstrate that spinal cord stimulation is effective for the treatment of chronic low back and radicular pain in carefully selected patients; scrupulous application of restrictive selection criteria is essential to the success of the method.
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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.