Articles: low-back-pain.
-
To compare periprocedural pain from mechanodesensitization (MD) with local anesthetic (LA) during medial branch blocks (MBBs), with a secondary outcome to compare diagnostic responses during the five hours postprocedure. ⋯ LA before needle insertion for MBBs appears to be more painful compared with MD. Additionally, subcutaneously administered local anesthetic may have a therapeutic effect on nonspecific low back pain, resulting in a potentially false-positive test in the evaluation of lumbar facet pain.
-
Randomized Controlled Trial
Effect of Electroacupuncture vs Sham Treatment on Change in Pain Severity Among Adults With Chronic Low Back Pain: A Randomized Clinical Trial.
Chronic low back pain has high societal and personal impact but remains challenging to treat. Electroacupuncture has demonstrated superior analgesia compared with placebo in animal studies but has not been extensively studied in human chronic pain conditions. ⋯ This randomized clinical trial found no statistically significant difference in change in PROMIS pain score in real electroacupuncture vs sham electroacupuncture. There was a statistically significant treatment effect for the secondary outcome of RMDQ compared with sham electroacupuncture. Effective coping skills and non-White race were associated with response to electroacupuncture.
-
Descriptors provided by patients with neuropathic low back pain (NLBP) with or without spinally referred leg pain are frequently used by clinicians to help to identify the predominant pain mechanisms. Indeed, many neuropathic screening tools are primarily based on subjective descriptors to determine the presence of neuropathic pain. There is a need to systematically review and analyse the existing evidence to determine the validity of such descriptors in this cohort. ⋯ Subjectively reported allodynia and numbness would suggest a neuropathic pain mechanism in LBP. Dysesthesia would raise the suspicion of NLBP. More research is needed to determine if descriptors suggesting autonomic dysfunction can identify NLBP. There is poor consensus on whether other descriptors can identify NLBP.
-
Emerg Med Australas · Oct 2020
Emergency department care for low back pain: Should we adopt recommendations from primary care guidelines?
ED visits for low back pain are increasing, but the lack of specific guidance for emergency physicians impedes evidence-based care, and adopting primary care recommendations may not be appropriate. The ED sees a different spectrum of low back pain presentations, where physicians are likely to encounter a larger proportion of patients with an underlying serious pathology or non-spinal diseases than in primary care. Current low back pain guidelines do not adequately cover screening for these conditions, but making a differential diagnosis is crucial in emergency patients with low back pain. In this article, we also discuss the challenges in developing specific ED guidelines for low back pain, the limited evidence on the profile of these patients and the surprising dearth of randomised trials.
-
Randomized Controlled Trial
Investigating the effects of myofascial induction therapy techniques on pain, function and quality of life in patients with chronic low back pain.
Low back pain (LBP) is well documented as a common health problem; it is the leading cause of activity limitation and work absence throughout much of the world, and it causes an enormous economic burden on individuals, families, communities, industry, and governments. The aim of this study was to comparatively investigate the effects of myofascial induction therapy (MIT) against pain neuroscience education (PNE) on pain and function in patients with chronic low back pain (CLBP). ⋯ Although both MIT and PNE were found to be effective on pain and function in patients with CLBP, MIT techniques were substantially better in improving the mobility of trunk flexion and quality of life in these patients.