Articles: low-back-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.
The Royal College of General Practitioners (RCGP) has produced guidelines for the management of acute low back pain in primary care. ⋯ The management of patients presenting with low back pain to primary care was mostly unchanged by an outreach educational strategy to promote greater adherence to RCGP guidelines among GPs. An increase in referral to physiotherapy or educational programmes followed the provision of a triage service.
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Randomized Controlled Trial Clinical Trial
Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial.
To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. ⋯ In chronic nonspecific low-back pain, significant and sustained reductions in pain and disability occur with ligament injections, irrespective of the solution injected or the concurrent use of exercises.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain.
The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) thermocoagulation of the ramus communicans nerve in patients suffering from chronic discogenic low back pain. ⋯ In patients with chronic discogenic low back pain, percutaneous RF denervation of the ramus communicans nerve should be considered as a treatment option.
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Randomized Controlled Trial Comparative Study Clinical Trial
The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction.
Recent work suggests that an expressive anger management style (anger-out) is associated with elevated acute pain sensitivity due to endogenous opioid antinociceptive dysfunction. We tested the hypothesis that this opioid dysfunction mediates the previously reported positive association between anger-out and chronic pain intensity. To assess endogenous opioid antinociception in the laboratory, 71 subjects with chronic low back pain received opioid blockade (8 mg naloxone i.v.) or placebo in counterbalanced order in separate sessions. ⋯ Inclusion of blockade effects in the first step of the regression resulted in a decrease from 7 to 3% in chronic pain variance accounted for by anger-out. Opioid dysfunction did not mediate the positive association between anger-in and chronic pain. These results provide preliminary support for the hypothesis that the positive association between anger expression and chronic pain intensity is mediated by opioid antinociceptive system dysfunction.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Acupuncture for chronic low back pain in older patients: a randomized, controlled trial.