Articles: low-back-pain.
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Randomized Controlled Trial
A randomized controlled trial of ibuprofen versus ketorolac versus diclofenac for acute, nonradicular low back pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medication for acute low back pain (LBP). It is unclear if the choice of NSAID impacts outcomes. We compared ibuprofen, ketorolac, and diclofenac for the treatment of acute, nonradicular LBP. ⋯ There were no important differences between groups with regard to the primary outcome. These data do not rule out that possibility that ketorolac results in better pain relief and less stomach irritation than ibuprofen.
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The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, validated mapping algorithm. ⋯ The rate of patients with predicted limitations/restrictions in activity/participation ICF core categories for cLBP partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions in ICF categories was varied. Thus, assessing problems in the ICF activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.
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Case Reports
A alternative approach for lumbar transforaminal epidural steroid injection-Far lateral approach.
Transforaminal epidural steroid injection (TFESI) is one of the nonoperative interventions for lower back pain. In this study, we presented an alternative approach for TFESI, far lateral lateral recess TFESI (FLLR TFESI), which is targeted on lateral recess and anterior epidural space in patients with degenerative lumbar spondylosis-related radiculopathy. ⋯ FLLR TFESI is a modified fluoroscopic technique targeted on lateral recess and anterior epidural space. However, subsequent trials are needed to confirm its efficacy in pain reduction and the rate of complications.
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Multicenter Study
Treatment of Chronic Axial Back Pain with 60-day Percutaneous Medial Branch PNS: Primary Endpoint Results from a Prospective, Multicenter Study.
The objective of this prospective, multicenter study is to characterize responses to percutaneous medial branch peripheral nerve stimulation (PNS) to determine if results from earlier, smaller single-center studies and reports were generalizable when performed at a larger number and wider variety of centers in patients recalcitrant to nonsurgical treatments. ⋯ Given the minimally invasive, nondestructive nature of percutaneous PNS and the significant benefits experienced by participants who were recalcitrant to nonsurgical treatments, percutaneous PNS may provide a promising first-line neurostimulation treatment option for patients with chronic axial back pain.