Articles: low-back-pain.
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Low back pain (LBP) is a chronic condition that causes great individual suffering and economic burden. The major contributor of LBP is intervertebral disc degeneration (IDD), which is caused by a spectrum of homeostasis alteration, including the apoptosis of nucleus pulposus (NP) and annulus fibrosus (AF) cells, degradation of extracellular matrix (ECM), calcification of cartilaginous endplates (CEP) and so on. Currently, the therapeutic strategy for IDD includes conservative and surgery treatment. ⋯ Increasing evidence implicates that exosomes could impact the intracellular transcription activities, thereby inhibiting or accelerating the proliferation and apoptosis of cells. Thus, it is a new therapeutic source for IDD. This review chiefly focuses on generalizing and clarifying the roles of exosomes in the onset and deterioration of IDD, and their therapeutic potential.
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Endoscopic rhizotomy (ER) of the medial branch has been recently developed for the treatment of lumbar facet joint pain (LFJP). However, there are no studies comparing the pain-free duration after ER and radiofrequency (RF). ⋯ Both ER and RF can improve the pain and physical function in patients with LFJP. ER is associated with a longer operative duration and medical expenses; however, it provides more sustained efficacy than RF. The surgical choice should depend on the patients' specific conditions.
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Patients experience variable long-term improvement in chronic back pain despite successful spinal cord stimulation (SCS) trials. Iliopsoas (IP) size has been shown to differ between patients with low back pain and healthy controls. In this study, we examine whether the IP muscle cross-sectional area (CSA) is associated with SCS outcomes. ⋯ Our study showed that psoas measurements correlated with various pain outcomes specifically. P/VBA was most predictive in females and P/BMI in males. Depression correlated with P/BMI, reinforcing the complex relationship between depression and constant chronic pain. Tertile analyses further showed a relationship between iliopsoas CSA and depression in males and females. We provide preliminary data of sex-specific psoas measurements as a risk factor for worse SCS outcomes.
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The coronavirus 2019 (COVID-19) pandemic led to a compulsory lockdown of 3 months with strict restrictions. The impact of the COVID-19 pandemic has shown broad repercussions on patients with chronic pain; especially for conditions that present a significant emotional participation such as chronic low back pain (cLBP). ⋯ Lockdown affected the somatic component of cLBP by decreasing activities and physical measures, whereas the SARS-CoV-2 pandemic spectrum paradoxically improved the psychic and emotional component of cLBP.
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Journal of women's health · Jan 2022
Prescribing Analgesics for Low Back Pain: Is There a Gender Difference?
Background: Gender differences have been described in many fields of pain. However, research is inconclusive as to gender difference in pain management. Our study aimed to investigate gender differences in prescribing analgesics for low back pain. ⋯ Conclusion: Men and women were similarly prescribed analgesics for low back pain. Men were more likely than women to be prescribed strong opioids. Further research is needed to evaluate the outcomes of this differential treatment.