Articles: low-back-pain.
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J Altern Complement Med · Sep 2019
Randomized Controlled Trial Comparative StudyEffectiveness of Hatha Yoga Versus Conventional Therapeutic Exercises for Chronic Nonspecific Low-Back Pain.
Objective: To determine whether the effectiveness of Hatha yoga therapy is comparable to conventional therapeutic exercises (CTEs) for reducing back pain intensity and back-related dysfunction in patients with chronic nonspecific low-back pain (CNLBP). Design: The study was a prospective randomized comparative trial, divided into two phases: an initial 6-weekly supervised intervention period followed by a 6-week follow-up period. Settings: This study was conducted at Department of Physical Medicine and Rehabilitation and Centre for Integrative Medicine and Research of a tertiary care hospital. Subjects: Patients between 18 and 55 years of age with complaint of CNLBP persisting ≥12 weeks with pain rating ≥4 on a numerical rating scale (0-10). Intervention: A total of six standardized 35-min weekly Hatha yoga sessions (yoga group) and similarly 35-min weekly sessions of CTEs (CTE group), designed for people with CNLBP unaccustomed to structured yoga or CTE program. Participants were asked to practice on nonclass days at home. Outcome measures: The primary outcome measures were Defense and Veterans Pain Rating Scale (DVPRS) (0-10) and 24-point Roland Morris Disability Questionnaire (RDQ). Secondary outcomes were pain medication usage per week and a postintervention Perceived recovery (Likert seven-point scale) of back-related dysfunction. ⋯ Both yoga and the CTE group have shown significant improvement in back pain intensity and back-related dysfunction within both the groups at 6- and 12-week follow-ups compared to baseline. No statistically significant differences in the pain intensity (DVPRS; at 6 weeks: n = 35, difference of medians 1.0, 95% confidence interval [-5.3 to 3.0], p = 0.5; at 12 weeks: n = 35, 0.0 [-4.2 to 5.0], 0.7) and back-related dysfunction (RDQ; at 6 weeks: n = 35, 1.0 [-9.6 to 10.6], 0.4; at 12 weeks: n = 35, 0.0 [-8.8 to 10.6], 0.3) were noted between two groups. Improvements in pill consumption and perceived recovery were also comparable between the groups. Conclusion: Yoga provided similar improvement compared with CTEs, in patients with CNLBP.
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A cross-sectional, retrospective cohort study. ⋯ 3.
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Consultation-based reassurance for patients with low back pain (LBP) in primary care has been shown to be associated with patients' outcomes. Little is known about the role of reassurance in people with LBP consulting with orthopaedic spinal care teams. Reassurance may be important, especially in cases where surgery is not indicated and patients are discharged without treatment. ⋯ This study describes narratives from patients discharged without surgery following consultations with orthopaedic professionals for persistent and debilitating lower back pain. Findings suggest that these interactions are distressful to patients, and that patients require comprehensive and specific reassurance to promote self-management. The findings contribute a unique insight into the special needs of people with complex pain problems and provide guidance to improve consultation-based reassurance in orthopaedic spinal care settings.
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This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. ⋯ Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.