Articles: low-back-pain.
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Randomized Controlled Trial
Relief of low back labor pain by using intracutaneous injections of sterile water: a randomized clinical trial.
To study the effectiveness of intracutaneous injections of sterile water in relieving low back pain during labor in Thai women. ⋯ The intracutaneous injections of sterile water was found to be an effective treatment against lower back pain during the first stage of labor.
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Randomized Controlled Trial
The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial.
Randomized controlled trial. ⋯ The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up.
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Randomized Controlled Trial
The association between psychopathology and placebo analgesia in patients with discogenic low back pain.
Chronic low back pain patients have a high rate of psychopathology, comprised mainly of depression, anxiety, and high levels of neuroticism. We previously found that psychopathology is associated with increased placebo analgesia in this patient group. ⋯ This study indicates that high and moderate levels of psychopathology are associated with heightened placebo analgesia in chronic low back pain patients. Expectations were only an influence in the high psychopathology group, and neuropathic pain affects placebo responses. These findings have implications for future research characterizing placebo responders.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
The ACTION study: a randomized, open-label, multicenter trial comparing once-a-day extended-release morphine sulfate capsules (AVINZA) to twice-a-day controlled-release oxycodone hydrochloride tablets (OxyContin) for the treatment of chronic, moderate to severe low back pain.
This large, open-label, randomized, parallel-group, multicenter study compared two oral sustained-release opioids (SROs)--AVINZA (A-MQD), morphine sulfate extended-release capsules given once a day, and OxyContin (O-ER), oxycodone modified-release tablets given twice a day--in SRO-naive subjects ages 30 to 70 with chronic, moderate to severe low back pain. Of the 392 subjects enrolled and randomized, 266 (132 in the A-MQD group and 134 in the O-ER group) completed the opioid dose titration phase and entered an eight-week evaluation phase. During the evaluation phase, A-MQD achieved significantly better pain control than O-ER, as demonstrated by a greater decrease from baseline in pain scores obtained four times daily during weeks one, four, and eight (p = 0.002). ⋯ The incidence and severity of elicited opioid side effects were similar in the two groups. This trial demonstrated that once-daily A-MQD provides consistent around-the-clock pain relief in patients with low back pain. In patients who completed opioid dose titration, A-MQD was significantly better than O-ER for reducing pain and improving sleep, while requiring a lower daily opioid dose.
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Randomized Controlled Trial
Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial.
The process through which new scientific developments are incorporated into clinical practice is referred to as "knowledge transfer" and is currently the subject of great interest in many areas of clinical medicine. Family physicians managing patients with acute low back pain have been shown to have a poor overall rate of concordance with clinical practice guideline-recommended treatments. New methods need to be developed to help physicians bridge the guideline implementation gap. ⋯ A knowledge transfer method that involved patient-specific, physician-to-physician communication to family physicians or their patients at three stages of the patient's clinical course was largely unsuccessful in improving concordance with guideline treatment recommendations.