Articles: low-back-pain.
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In the United Kingdom (UK), 9% of adults consult their doctor annually with back pain. The treatment recommendations are based on orthopaedic teaching, but the current management is causing increasing dissatisfaction. Many general practitioners (GPs) are confused about what constitutes effective advice. ⋯ A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.
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J. Heart Lung Transplant. · Oct 1997
Review Case ReportsInsufficiency fractures of the sacrum: a cause of low back pain after lung transplantation.
Insufficiency fractures of the sacrum were diagnosed during the first year after successful transplantation in four (5.6%) of 71 lung and heart-lung transplant recipients. Each patient had development of low back pain after minor or no trauma; all had osteoporosis. In each instance, plain radiographs failed to demonstrate the fracture, and the diagnosis was established by radionuclide bone scanning that demonstrated the characteristic "butterfly" (bilateral sacral fracture) or "half-butterfly" appearance (unilateral sacral fracture). Sacral insufficiency fractures, a significant cause of low back pain in lung transplant recipients, may be underdiagnosed in this population because routine radiographs do not usually reveal the fracture; bone scanning is the preferred diagnostic modality.
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Acta Obstet Gynecol Scand · Oct 1997
Review Randomized Controlled Trial Comparative Study Clinical TrialOral contraceptive use among female elite athletes and age-matched controls and its relation to low back pain.
Exogenous and endogenous female sex steroids may influence the risk of low back pain. The fact that back pain is a very common symptom during pregnancy supports this theory. Back pain is also more common among female than male athletes. Oral contraceptives have been suggested to increase the risk of low back pain. ⋯ This study does not support the theory that low back pain is affected by the use of oral contraceptives. Instead, constitutional factors and mechanical stress during intense physical activity is probably more important.
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A systematic review of randomized controlled trials. ⋯ The quality of the design, execution, and reporting of randomized controlled trials should be improved, to establish strong evidence for the effectiveness of the various therapeutic interventions for acute and chronic low back pain.
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Within the past decades, epidural steroid injections have been used in the treatment of severe low back pain and sciatica. In reviewing papers for this article an effort is made to concentrate on those that meet commonly accepted research design criteria, such as being blinded, randomized and prospective. The risks and the advantages of the procedure are discussed. ⋯ Risks of more serious complications are low using the right technique. However, the results are to some extent conflicting. Future correctly designed studies are necessary to clarify whether the injection should be a supplement to the established treatment of low back pain and sciatica.