Articles: low-back-pain.
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Together, neck pain and back pain are the first cause of disability worldwide, accounting for more than 10% of the total years lived with disability. In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. ⋯ SIGNIFICANCE: Spinal manipulation inhibits back and neck pain partly through spinal segmental mechanisms and potentially through peripheral mechanisms regulating inflammatory responses. Other mechanisms remain to be clarified. Controls and placebo interventions need to be improved in order to clarify the contribution of specific and non-specific effects to pain relief by spinal manipulative therapy.
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Peripheral nerve field stimulation (PNFS) is an effective alternative treatment for patients with chronic low back pain. Transcutaneous electrical nerve stimulation (TENS) is frequently used in pain therapy. Aim of this prospective study was to examine the predictive value of TENS for later PNFS treatment. ⋯ TENS can be predictive for patient selection in PNFS, as TENS positive patients showed significant correlation with a positive PNFS trial period. Therefore, TENS positive patients might be justifiable to be directly implanted with leads and IPG. TENS positive patients further tend to show a better improvement in the follow-up.
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This study's objective was to assess biomechanical parameters across fused and contralateral sacroiliac joints (SIJs) and implants during all spinal motions for both sexes. Various SIJ implant devices on the market are used in minimally invasive surgeries. These implants are placed across the joint using different surgical approaches. The biomechanical effects of fusion surgical techniques in males and females have not been studied. ⋯ Implants exhibited higher stresses in the female model compared to the male model. However, chances of SIJ implant failure in the female patients are still minimal, based on the calculated factor of safety which is still very high. Both lateral and posterior surgical approaches were effective in both sexes; however, the lateral approach may provide a better biomechanical response, especially for females. Moreover, implant design characteristics did not make a difference in the implants' biomechanical performance. SIJ stabilization was primarily provided by the implants which were the farthest from the sacrum rotation center.
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The purpose of the ongoing follow-up of ReActiv8-A clinical trial is to document the longitudinal benefits of episodic stimulation of the dorsal ramus medial branch and consequent contraction of the lumbar multifidus in patients with refractory mechanical chronic low back pain (CLBP). We report the four-year outcomes of this trial. ⋯ In participants with disabling intractable CLBP who receive long-term restorative neurostimulation, treatment satisfaction remains high and improvements in pain, disability, and quality-of-life are clinically meaningful and durable through four years.