Articles: low-back-pain.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Psychometric properties of the functional rating index in patients with low back pain.
The purpose of this study was to validate the psychometric properties of the functional rating index (FRI), establish the instrument's minimum clinically important difference (MCID), and compare its psychometric properties with the Oswestry questionnaire. ⋯ The FRI is less reliable than the Oswestry but appears to have comparable validity and responsiveness. Before the FRI can be recommended for widespread use in patients with neck and low back pain, it should be further tested in patients with neck pain.
-
Chronic lumbar radicular pain is the most common neuropathic pain syndrome. This was a double-blind, randomized, 2-period crossover trial of topiramate (50 to 400 mg) and diphenhydramine (6.25 to 50 mg) as active placebo to assess the efficacy of topiramate. Each period consisted of a 4-week escalation, a 2-week maintenance at the highest tolerated dose, and a 2-week taper. Main outcome was the mean daily leg pain score on a 0 to 10 scale during the maintenance period. Global pain relief was assessed on a 6-level category scale. In the 29 of 42 patients who completed the study, topiramate reduced leg pain by a mean of 19% (P = .065). Global pain relief scores were significantly better on topiramate (P < .005). Mean doses were topiramate 200 mg and diphenhydramine 40 mg. We concluded that topiramate treatment might reduce chronic sciatica in some patients but causes frequent side effects and dropouts. We would not recommend topiramate unless studies of alternative regimens showed a better therapeutic ratio. ⋯ The anticonvulsant topiramate might reduce chronic lumbar nerve root pain through effects such as blockade of voltage-gated sodium channels and AMPA/kainite glutamate receptors, modulation of voltage-gated calcium channels, and gamma-aminobutyric acid agonist-like effects.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Transdermal fentanyl versus sustained release oral morphine in strong-opioid naïve patients with chronic low back pain.
Open, randomized, parallel group multicenter study. ⋯ TDF and SRM provided equivalent levels of pain relief, but TDF was associated with less constipation. This study indicates that sustained-release strong opioids can safely be used in strong-opioid naïve patients.
-
Randomized Controlled Trial Comparative Study
A randomized, controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain.
This article examines the effectiveness of manual therapy with specific adjuvant exercise for treating chronic low back pain and disability. ⋯ Manual therapy with specific adjuvant exercise appears to be beneficial in treating chronic low back pain. Despite changes in pain, perceived function did not improve. It is possible that impacting chronic low back pain alone does not address psychosocial or other factors that may contribute to disability. Further studies are needed to examine the long-term effects of these interventions and to address what adjuncts are beneficial in improving function in this population.
-
Randomized Controlled Trial Clinical Trial
Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome.
To prospectively determine in patients with acute low back pain (LBP) or radiculopathy, the magnetic resonance (MR) imaging findings, prognostic role of these findings, and effect of diagnostic information on outcome. ⋯ In typical patients with LBP or radiculopathy, MR imaging does not appear to have measurable value in terms of planning conservative care. Patient knowledge of imaging findings does not alter outcome and is associated with a lesser sense of well-being.