Articles: low-back-pain.
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Randomized Controlled Trial Multicenter Study
Patients With Chronic Spinal Pain Benefit From Pain Neuroscience Education Regardless the Self-Reported Signs of Central Sensitization: Secondary Analysis of a Randomized Controlled Multicenter Trial.
Pain neuroscience education is effective in chronic pain management. Central sensitization (ie, generalized hypersensitivity) is often explained as the underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome. ⋯ I.
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Meta Analysis
Imaging for low back pain: is clinical use consistent with guidelines? A systematic review and meta-analysis.
The problem of imaging patients with low back pain (LBP) when it is not indicated is well recognized. The converse is also possible, although rarely considered. The extent of these two problems is presently unclear. ⋯ Inappropriate imaging is common in LBP management, including both overuse in those where imaging is not indicated and underuse of imaging when it is indicated. Appreciating that both underuse and overuse can occur is fundamental to efforts to improve imaging practice to align with current guidelines and best evidence.
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Journal of anesthesia · Dec 2018
Suppressed descending pain modulatory and enhanced sensorimotor networks in patients with chronic low back pain.
Although cerebral structural and functional changes were uncovered by neuroimaging in patients with chronic low back pain (CLBP), their associations remain to be clarified. We co-analyzed anatomical and functional magnetic resonance imaging data in those patients and tested whether cortical gray matter volume changes are associated with altered pain modulatory networks underlying chronification of pain. ⋯ Patients showed a decreased volume of cortical center for descending pain modulation and an increased volume of sensorimotor network, in association with suppressed descending pain modulatory and cerebellum-limbic networks and enhanced sensorimotor network during pain. Such structural and functional alterations might be part of cerebral pathophysiology of CLBP.
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Growing evidence suggests that chronic low back pain (CLBP) is associated with pain sensitization, and that there are sex and race disparities in CLBP. Given the sex and race differences in pain sensitization, this has been hypothesized as a mechanism contributing to the sex and race disparities in CLBP. This study examined sex and race differences in pain sensitization among patients with CLBP, as well as the role of catastrophizing as a potential mediator of those differences. ⋯ PERSPECTIVE: This study identifies sex and race differences in pain sensitization among patients with CLBP. Further, it recognizes the role of catastrophizing as a contributor to such race differences. More research is needed to further dissect these complex relationships.
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J Electromyogr Kinesiol · Dec 2018
Comparative StudyCompensatory strategy between trunk-hip kinematics and reaction time following slip perturbation between subjects with and without chronic low back pain.
Compensatory trunk and hip motions following slip perturbations may compromise the control of lumbopelvic movement. However, it is unclear how postural integration of the trunk and hips can be transferred to treadmill-induced slip perturbations in subjects with chronic low back pain (LBP). The purpose of this study was to investigate trunk reaction times and three-dimensional trunk-hip angle changes following a slip perturbation (duration: 0.12 sec, velocity: 1.37 m/sec, displacement: 8.22 cm) with a handheld task between subjects with and without chronic LBP. ⋯ Clinicians need to consider compensatory strategies to improve trunk flexibility following slip perturbations in subjects with chronic LBP. Mini abstract: Trunk reaction time and three-dimensional trunk-hip motions were compared between subjects with and without chronic low back pain (LBP). The control group demonstrated greater trunk flexion; however, the LBP group reduced trunk flexion to protect against further injuries following the novelty of the slip perturbation.