Articles: low-back-pain.
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Neurological research · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain.
Low back pain is one of the most significant medical and socioeconomic problems in modern society. International guidelines call for evidence-based management for the pain and disability associated with musculoskeletal disorders. The purpose of this randomized controlled trial is to address the question of efficacy and appropriateness of vertebral axial decompression (VAX-D) therapy, a new technology that has been shown in clinical research to create negative intradiscal pressures, and has been shown to be effective in treating patients presenting with chronic low back pain (> 3 months duration) with associated leg pain. ⋯ Patients were randomly assigned to VAX-D or to TENS which was used as a control treatment or placebo. The TENS treatment demonstrated a success rate of 0%, while VAX-D demonstrated a success rate of 68.4% (p < 0.001). A statistically significant reduction in pain and improvement in functional outcome was obtained in patients with chronic low back pain treated with VAX-D.
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialEfficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials.
The use of radiofrequency (RF) procedures in the peripheral nervous system to treat chronic spinal pain has been the subject of controversy. Publications concerned only uncontrolled studies, and irreversible nervous tissue damage was believed to be responsible for the effect, if any. In recent years, randomized, controlled studies have appeared, which have attested to an increasing use of these techniques. This is a systematic review of randomized controlled trials on RF procedures for spinal pain. ⋯ We conclude that there is moderate evidence that RF lumbar facet denervation is more effective for chronic low back pain than placebo. Limited evidence exists for efficacy of RF neurotomy in chronic cervical zygapophyseal joint pain after flexion-extension injury. There is limited evidence that RF heating of the dorsal root ganglion is more effective than placebo in chronic cervicobrachialgia. We recommend the systematic application of our additional parameter assessments for future evaluations of RF studies. These additional parameters should also be used in the preparation of future trial protocols of RF procedures for the treatment of chronic pain.
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Randomized Controlled Trial Clinical Trial
No significant differences between intervention programmes on neck, shoulder and low back pain: a prospective randomized study among home-care personnel.
The effects of two different prevention programmes on: (1) reported neck, shoulder and back pain, (2) perceived physical exertion at work and perceived work-related psychosocial factors, were evaluated by questionnaires after 12 and 18 months. Female nursing aides and assistant nurses (n = 282) working in the home-care services, were randomly assigned to one of three groups for: (1) individually designed physical training programme, (2) work-place stress management, (3) control group. Results revealed no significant differences between the three groups. ⋯ Improvements in neck and shoulder pain did not differ within the three groups. Dissatisfaction with work-related, psychosocial factors was generally increased in all groups. As the aetiology of neck, shoulder and back disorders is multifactorial, a combination of the two intervention programmes might be preferable and should be further studied.
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Randomized Controlled Trial Clinical Trial
Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects.
A subanalysis of data derived from a randomized clinical trial was performed. ⋯ The results of this study suggest that patient expectations may influence clinical outcome independently of the treatment itself. In contrast, general optimism about treatment, divorced from a specific treatment, is not strongly associated with outcome. These results may have important implications for clinical trial design and recruitment, and may help to explain the apparent success of some conventional and alternative therapies in trials that do not control for patient expectations. The findings also may be important for therapy choices made in the clinical setting.
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Randomized Controlled Trial Clinical Trial
Radiofrequency facet joint denervation in the treatment of low back pain: a placebo-controlled clinical trial to assess efficacy.
A prospective double-blind randomized controlled trial was performed. ⋯ Although radiofrequency facet joint denervation may provide some short-term improvement in functional disability among patients with chronic low back pain, the efficacy of this treatment has not been established.