Articles: low-back-pain.
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Randomized Controlled Trial Clinical Trial
Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.
We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting. ⋯ These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.
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Randomized Controlled Trial Comparative Study
The association between negative affect and opioid analgesia in patients with discogenic low back pain.
Comprised mainly of depression, anxiety, and high neuroticism, psychopathology diminishes the effectiveness of many chronic pain treatments. But, it is not known if it is associated with diminished opioid analgesia in patients with chronic, noncancer pain. We tested the hypothesis that psychopathology diminishes opioid analgesia in patients with discogenic low back pain in 60 patients not on opioids in a double blind, placebo controlled, random crossover designed trial. ⋯ A morphine minus placebo analgesia calculation revealed 59.2% TOTPAR in the LOW group vs. 21.7% in the HIGH group, P=.0001. High levels of psychopathology are associated with diminished opioid analgesia in patients with discogenic low back pain. These results have implications for the prescription of oral opioids to patients with chronic low back pain and psychopathology.
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Reg Anesth Pain Med · Sep 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA prospective crossover comparison study of the single-needle and multiple-needle techniques for facet-joint medial branch block.
Medial branch blocks have been widely described in the literature as a diagnostic tool for facet joint pain. Recently, a new "single-needle' technique was described that is purported to be equally accurate, and in some respects, superior to the standard multiple-needle technique. To date, no studies have been performed that compared these 2 techniques. ⋯ Our results indicate that the single-needle technique takes less time to perform and causes less patient discomfort than does the standard technique but provides the same degree of accuracy. More studies with larger sample sizes are needed to corroborate these results and explore the effect the single-needle approach has on the rate of false-positive medial branch blocks.
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Arch Phys Med Rehabil · Sep 2005
Randomized Controlled Trial Comparative Study Clinical TrialLumbar spine segmental mobility assessment: an examination of validity for determining intervention strategies in patients with low back pain.
To examine the predictive validity of posterior-anterior (PA) mobility testing in a group of patients with low back pain (LBP). ⋯ Patients with LBP judged to have lumbar hypomobility experienced greater benefit from an intervention including manipulation; those judged to have hypermobility were more likely to benefit from a stabilization exercise program.
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J Manipulative Physiol Ther · Sep 2005
Randomized Controlled Trial Comparative StudyA randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome.
To investigate the effect of instrument-delivered compared with traditional manual-delivered thrust chiropractic adjustments in the treatment of sacroiliac joint syndrome. ⋯ The results indicate that a short regimen of either mechanical-force, manually-assisted or high-velocity, low-amplitude chiropractic adjustments were associated with a beneficial effect of a reduction in pain and disability in patients diagnosed with sacroiliac joint syndrome. Neither mechanical-force, manually-assisted nor high-velocity, low-amplitude adjustments were found to be more effective than the other in the treatment of this patient population.