Articles: low-back-pain.
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Because imaging findings of lumbar spinal stenosis (LSS) may not be associated with symptoms, clinical classification criteria based on patient symptoms and physical examination findings are needed. ⋯ Clinical criteria independently associated with neurogenic claudication due to LSS were identified. The use of these symptom and physical variables as a classification score for clinical research could improve homogeneity among enrolled patients.
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To investigate the correlates of a recent history of disabling low back pain (LBP) in older persons. ⋯ Our study supports the link between disabling LBP and other age-related chronic conditions in a middle-income country with a rapidly aging population.
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The aim of this study was to identify associations between early care decisions and long-term opioid (LTO) use in opioid-naïve patients with a new physician consultation for low back pain (LBP) at which an opioid was prescribed. ⋯ Early care decisions were predictive of LTO use following a new LBP consultation at which opioids were prescribed. Our results support recommendations to avoid concurrent benzodiazepine prescribing and to consider other evidence-based pain treatments such as physical therapy early, particularly for patients at high risk for LTO use or misuse.
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Low back pain (LBP) is the most commonly reported chronic pain condition. In this study, a clinically relevant, induced-LBP paradigm was used to study sensory processing as a risk factor and predictor for LBP development in healthy people. Our aim was to examine sensory processing in those who do develop LBP and those who do not develop LBP with the paradigm, and to examine the relationships between scores on psychosocial questionnaires and sensory processing measures in these healthy people. ⋯ These results provide evidence that altered sensory processing was not present in healthy people and thus is not a risk factor for development of LBP in standing.
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Comparative Study
Advanced musculoskeletal physiotherapists are effective and safe in managing patients with acute low back pain presenting to emergency departments.
Objective The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners). Methods A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED. ⋯ The specific improved metrics for these patients were decreased admission rates, decreased ED length of stay and decreased wait time. What are the implications for clinicians? This paper provides evidence that the AMPs effectively discharge patients admitted to the ED in a timely manner, without evidence of increased readmissions, compared with their medical and nursing colleagues. Support for the role of the AMP within the ED setting is strengthened by these results.