Articles: low-back-pain.
-
Randomized Controlled Trial
Percutaneous Intradiscal Radiofrequency Thermocoagulation Combined with Sinuvertebral Nerve Ablation for the Treatment of Discogenic Low Back Pain.
Percutaneous intervertebral radiofrequency thermocoagulation (PIRFT) and sinuvertebral nerve ablation (SVNA) are commonly used clinical treatments for discogenic low back pain (DLBP). However, they have been reported to have low efficacy rates of approximately 16.5%-26.5%, especially in the medium to long term. ⋯ In DLBP, the sinuvertebral nerve (SVN) is the main nerve involved in the lumbar disc pain signaling pathway, and compared with PIRFT and SVNA alone, combined PIRFT and SVNA treatment may provide more satisfactory pain relief and functional improvement at an early stage.
-
Multicenter Study Observational Study
Prolonged opioid use after single-level lumbar spinal fusion surgery in a Belgian population: a multicentric observational study.
Lumbar spinal fusion surgeries are increasingly being performed in spinal degenerative disease, often accompanied by perioperative opioid prescriptions. The aim of this study is to analyze prolonged postoperative opioid use following a standardized opioid prescription after single-level lumbar spinal fusion surgery in a Belgian population. ⋯ 1 in 3 patients undergoing single-level lumbar spinal fusion surgery is at risk for prolonged opioid use. The study underscores the importance of tailored pain management strategies, particularly given the rising prevalence of spinal fusion surgeries. The association between pre-operative low back pain, post-operative improvement in functionality (ODI), and prolonged opioid use emphasizes the need for judicious opioid prescribing practices and highlights the role of functional outcomes in treatment goals.
-
Despite the routine use of radiofrequency (RF) for the treatment of chronic pain in the lumbosacral and cervical region, there remains uncertainty on the most appropriate patient selection criteria. This study aimed to develop appropriateness criteria for RF in relation to relevant patient characteristics, considering RF ablation (RFA) for the treatment of chronic axial pain and pulsed RF (PRF) for the treatment of chronic radicular pain. ⋯ A multidisciplinary European expert panel established patient-specific recommendations that may support the (pre)selection of patients with chronic axial and radicular pain in the lumbosacral and cervical region for either RFA or PRF (accessible via https://rftool.org). Future studies should validate these recommendations by determining their predictive value for the outcomes of (P)RF interventions.
-
Yoga has been recognized for its many mental and physical health benefits. A growing body of literature supports yoga's indication in chronic low back pain (CLBP) management. CLBP is a major public health concern, given its high rates of associated disabilities and large healthcare costs. A biopsychosocial approach has been deemed the most effective and appropriate management strategy for this condition. When alternative and comprehensive approaches for managing the complexity of CLBP are considered, yoga poses a safe, accessible adjunctive treatment option. ⋯ Overall, the current management strategies for CLBP do not encompass an effective biopsychosocial approach, and an intervention such as yoga is a promising adjunctive treatment for the condition.
-
Pain hypersensitivity is present in some people with acute low back pain (LBP) and thought to be involved in the development of chronic LBP. Early evidence suggests that pain hypersensitivity in acute LBP precedes poor long-term outcome. We aimed to examine whether the presence of pain hypersensitivity in acute LBP influenced recovery status at 6 months and differentiated how pain and disability changed over time. ⋯ PERSPECTIVE: Pain hypersensitivity is thought to be involved in the transition to chronic LBP. Contradictory to prevailing hypothesis, our findings suggest pain hypersensitivity alone in acute LBP does not precede poor recovery. High psychological distress in acute LBP has a stronger influence than pain hypersensitivity on long-term disability, but not pain outcomes.