Articles: low-back-pain.
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Arch Phys Med Rehabil · Feb 2020
Conservative Interventions Reduce Fear in Individuals With Chronic Low Back Pain: A Systematic Review.
To systematically review and critically appraise the effectiveness of conservative and surgical interventions to reduce fear in studies of people with chronic low back pain, based on the analysis of randomized controlled trials for which fear was a primary or secondary outcome. ⋯ The present systematic review highlights the potential effectiveness of conservative interventions to reduce kinesiophobia and fear-avoidance beliefs in individuals with chronic low back pain. This information can help health professionals to reduce fear when treating patients with this condition.
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Choosing Wisely Canada (CWC) guidelines recommend that in the absence of clinical indicators suggestive of serious underlying pathology, physicians should not order radiological imaging for patients presenting with nonspecific low back pain (LBP). ⋯ CWC guidelines did not appear to alter the rate of imaging for patients presenting to the ED with nontraumatic LBP. Future clinical recommendations should consider active knowledge dissemination and education strategies to help facilitate guideline adoption.
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J Manipulative Physiol Ther · Feb 2020
Randomized Controlled TrialClassification-Specific Treatment Improves Pain, Disability, Fear-Avoidance Beliefs, and Erector Spinae Muscle Activity During Walking in Patients With Low Back Pain Exhibiting Lumbar Extension-Rotation Pattern: A Randomized Controlled Trial.
Low back pain (LBP) has commonly been managed via classification-specific interventions in homogeneous groups. However, it is largely unknown whether treatment tailored to specific classifications is more effective than generic treatment. The purpose of this study was to evaluate the effects of classification-specific treatment on the self-reported responses and erector spinae (ES) activity of patients with LBP exhibiting a lumbar extension-rotation (ExtRot) pattern. ⋯ Classification-specific treatment may be effective in patients with LBP exhibiting the lumbar ExtRot pattern, reducing pain intensity, disability, fear-avoidance beliefs, and ES muscle activity during walking.
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A combination of physical examination maneuvers is currently considered necessary to help predict who will respond to injections in the sacroiliac joint. However, the literature on this topic currently consists of conflicting studies, with one showing the value of a combination of exam maneuvers and the other showing no real value. ⋯ In this cohort, patient physical exam maneuvers to identify intra-articular SIJ pain did not demonstrate diagnostic value when compared with the reference standard of an intra-articular anesthetic block.