Articles: low-back-pain.
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J Manipulative Physiol Ther · Jan 1993
Randomized Controlled Trial Clinical TrialThe Hmax/Mmax ratio as an outcome measure for acute low back pain.
To evaluate the use of the Hmax/Mmax (H/M) ratio as an outcome measure for acute low back pain and to determine the change of this ratio in acute low back pain patients treated with spinal manipulation. ⋯ The H/M ratio was found to be within normal limits in subjects with acute low back pain. The H/M ratio showed greater change in the group which received spinal manipulation, but the change was subtle. The results indicate that the H/M ratio may be of limited value in clinical practice.
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Two hundred chronic low-back pain patients entering a functional restoration program were assessed for current and lifetime psychiatric syndromes using a structured psychiatric interview to make DSM-III-R diagnoses. Results showed that, even when the somewhat controversial category of somatoform pain disorder was excluded, 77% of patients met lifetime diagnostic criteria and 59% demonstrated current symptoms for at least one psychiatric diagnosis. The most common of these were major depression, substance abuse, and anxiety disorders. ⋯ These are the first results to indicate that certain psychiatric syndromes appear to precede chronic low-back pain (substance abuse and anxiety disorders), whereas others (specifically, major depression) develop either before or after the onset of chronic low-back pain. Such findings substantially add to our understanding of causality and predisposition in the relationship between psychiatric disorders and chronic low-back pain. They also clearly reveal that clinicians should be aware of potentially high rates of emotional distress syndromes in chronic low-back pain and enlist mental health professionals to help maximize treatment outcomes.
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J Manipulative Physiol Ther · Jan 1993
Comparative StudyThe relationship between the St. Thomas and Oswestry disability scores and the severity of low back pain.
To investigate the relationship between the two disability questionnaires and low back pain severity using the visual analog scale (VAS). ⋯ The consequence of pain (disability) appears to have a weak relationship to pain severity. Despite the moderate correlation between the two disability questionnaires, it is suggested that they are not interchangeable.
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Low back pain is a common clinical symptom usually associated with mechanical disorders, primarily muscle strain, affecting the lumbosacral spine. The majority of patients with low back pain improve within a 2-month period with conservative medical management. Conservative management includes limited physical activity, injections, nonsteroidal anti-inflammatory drugs, and muscle relaxants. These therapies work best in combination and are very effective in decreasing low back pain.
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Comparative Study Clinical Trial
Chronic low back pain patients around the world: cross-cultural similarities and differences.
The current study sought to determine whether there were any significant cross-cultural differences in medical-physical findings, or in psychosocial, behavioral, vocational, and avocational functioning, for chronic low back pain patients. ⋯ It was concluded that there were important cross-cultural differences in chronic low back pain patients' self-perceived level of dysfunction, with the American patients clearly the most dysfunctional. Possible explanations included cross-cultural differences in social expectation; attention; legal-administrative requirements; financial gains; attitudes-expectations about usage, type, and availability of health care; and self-perceived ability and willingness to cope.