Articles: low-back-pain.
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Reg Anesth Pain Med · Jan 2019
Clinical TrialSelf-reported cumulative medical opioid exposure and subjective responses on first use of opioids predict analgesic and subjective responses to placebo-controlled opioid administration.
To expand the evidence base needed to enable personalized pain medicine, we evaluated whether self-reported cumulative exposure to medical opioids and subjective responses on first opioid use predicted responses to placebo-controlled opioid administration. ⋯ Self-reports of past exposure and responses to medical opioid analgesics may have utility for predicting subsequent analgesic responses and subjective effects. Further research is needed to establish the potential clinical and research utility of the HOME.
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In Scandinavia, women of childbearing age represent nearly 50% of the overall workforce. Two-thirds of these women spend a considerable time on sick leave during their pregnancies. Low back pain accounts for a significant portion of all pregnancy-related sick leave. However, pregnant women's experiences with pain-induced sick leave remains unexplored. ⋯ Our findings illuminate the possibilities for workplace adjustments with the intention of reducing time spent on sick leave, maintaining pregnant women's affiliation with their workplace, and a need to explore the role of healthcare professionals in addressing women's supportive needs in relation to sick leave.
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Introduced in 2007, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) has been widely used, but its psychometric properties have not been well studied. ⋯ The JOABPEQ domains are responsive measures in patients who undergo lumbar surgery. For physical function, the threshold for substantial clinically important differences was approximately 20 points for the JOABPEQ.
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Journal of pain research · Jan 2019
Therapeutic Efficacy and the Impact of the "Dose" Effect of Acupuncture to Treat Sciatica: A Randomized Controlled Pilot Study.
To investigate the required sample size for and feasibility of a full-scale randomized controlled trial examining the impact of the "dose" effect of acupuncture in treating sciatica. ⋯ Results of this pilot study indicate that acupuncture is safe and may effectively relieve symptoms and disability in patients with non-acute sciatica. MAL was as effective as MAH in treating sciatica. A subsequent trial with a larger sample size (estimated at n=96) is required to confirm whether patients with a high level of chronicity would benefit from MAH treatment.
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Clin Neurol Neurosurg · Jan 2019
Percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion for massive lumbar disc herniation.
To compare the clinical outcomes of patients with massive lumbar disc disease undergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion at a single clinic. ⋯ A comparison of PELD and MIS-TLIF for treating massive lumbar disc herniation revealed that both showed favorable clinical outcomes but had different sets of complications. Compared to MIS-TLIF, PELD had the following advantages: (1) its feasibility under local anesthesia and (2) the rarity of "fusion disease," such as ASD. However, the PELD is also revealed several problems, including a relatively lower success rate and satisfaction,a relative higher rate of postoperative long-term chronic low back pain and the possibility of recurrence, despite low opportunity. Therefore, the main difference between these two treatments was related to postoperative complications and the satisfaction and recovery rates. We suggest that, in the future, multi-center studies, recruiting a larger number of patients, should be undertaken to better understand the clinical relevance of these complications.