Articles: low-back-pain.
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The positive association between low back pain and MRI evidence of vertebral endplate bone marrow lesions, often called Modic changes (MC), offers the exciting prospect of diagnosing a specific phenotype of chronic low back pain (LBP). However, imprecision in the reporting of MC has introduced substantial challenges, as variations in both imaging equipment and scanning parameters can impact conspicuity of MC. This review discusses key methodological factors that impact MC classification and recommends guidelines for more consistent MC reporting that will allow for better integration of research into this LBP phenotype. ⋯ Comparison of MC data between studies can be problematic. Various methodological factors impact detection and classification of MC, and the lack of reporting guidelines hinders interpretation and comparison of findings. Thus, it is critical to adopt imaging and reporting standards that codify acceptable methodological criteria. These slides can be retrieved under Electronic Supplementary Material.
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Randomized Controlled Trial
Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study.
Low back pain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused by TrPs. ⋯ In this small randomized study with several methodological limitations, TPI was superior to the intravenous NSAIDs in the treatment of acute LBP due to TrPs. TPI can be used in the emergency departments for the acute treatment of LBP in selected patients.
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Musculoskelet Sci Pract · Oct 2019
Impact of flare-ups on the lives of individuals with low back pain: A qualitative investigation.
Investigating flare-ups has become relevant to understanding and managing low back pain (LBP), particularly because there has been a shift in the conceptualization of LBP from acute or chronic to fluctuating or episodic. Available research mainly consists of quantitative studies, which are unable to fully explore the perspectives of individuals with LBP. This study aimed to address this gap by exploring the changes in individual's lives when they experience LBP flare-up. ⋯ Results suggest the importance of considering that LBP flare-ups impact individuals' lives in a complex manner including psychosocial and functional effects. Clinicians should consider this complexity in their interactions with, and management of, patients with LBP flare-ups. Additional education may be required to better equip clinicians for these numerous aspects.
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J Manipulative Physiol Ther · Oct 2019
Coping and Management Techniques Used by Chronic Low Back Pain Patients Receiving Treatment From Chiropractors.
The purpose of this study was to describe coping strategies (eg, mechanisms, including self-treatment) that a person uses to reduce pain and its impact on functioning as reported by patients with chronic low back pain who were seen by doctors of chiropractic and how these coping strategies vary by patient characteristics. ⋯ Persons with chronic back pain were proactive in their coping strategies and frequently used self-care coping strategies like those provided by chiropractors in patient education. In alignment with patients' beliefs that their condition was chronic and lifelong, many patients attempted a wide range of coping strategies to relieve their pain.
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Low back pain (LBP) is a leading cause of disability associated with high healthcare utilisation and costs. Mental health symptoms are negative prognostic factors for LBP recovery; however, no population-based studies have assessed the joint effects of LBP and mental health symptoms on healthcare utilisation. This proposed study will characterise the health system burden of LBP and help identify priority groups to inform resource allocation and public health strategies. Among community-dwelling adult respondents of five cycles of the Canadian Community Health Survey (CCHS) in Ontario, we aim to assess the effect of self-reported LBP on healthcare utilisation and costs and assess whether this effect differs between those with and without self-reported mental health symptoms. ⋯ This study is approved by the University of Toronto Research Ethics Board. We will disseminate findings using a multifaceted knowledge translation strategy, including scientific conference presentations, publications in peer-reviewed journals and workshops with key knowledge users.