Articles: low-back-pain.
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Multicenter Study Clinical Trial
Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial.
It is critically important to evaluate the effect of nonpharmacological treatments on low back pain and associated disability. ⋯ Chiropractic care, when added to usual medical care, resulted in moderate short-term improvements in low back pain intensity and disability in active-duty military personnel. This trial provides additional support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines. However, study limitations illustrate that further research is needed to understand longer-term outcomes as well as how patient heterogeneity and intervention variations affect patient responses to chiropractic care.
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Randomized Controlled Trial Comparative Study
Electroacupuncture as a complement to usual care for patients with non-acute low back pain after back surgery: a pilot randomised controlled trial.
The aim of this pilot study was to estimate the sample size for a large pragmatic study of the comparative effectiveness of electroacupuncture (EA) for low back pain (LBP) after back surgery. ⋯ A future trial addressing the risk of bias and including the estimated sample size would allow for better clinical assessment of the benefits of EA plus UC in treatment of patients with non-acute pain after back surgery.
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Bmc Health Serv Res · May 2018
Randomized Controlled Trial Comparative StudyEffectiveness of a multifaceted implementation strategy compared to usual care on low back pain guideline adherence among general practitioners.
To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. ⋯ In the short term, the strategy did not result in improved guideline adherence among general practitioners, and it is not recommended for widespread use. However, baseline referral rates in participating practices were already low, possibly leaving only little room for improvement. Inquiries for psychosocial and occupational risk factors remained low and this leaves room for improvement.
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Randomized Controlled Trial
Comparison of Epidural Spreading Patterns and Clinical Outcomes of Transforaminal Epidural Steroid Injection with High-Volume Injectate via the Subpedicular Versus the Retrodiscal Approach.
The effect of transforaminal epidural steroid injection (TFESI) appears to be influenced by the volume of the injected material because there is a positive correlation between injection volume and extent of pain relief. ⋯ Epidural spreading patterns and clinical outcomes of lumbar TFESI with high-volume injectate were not significantly different between the SP approach and the RD approach.Institutional Review Board (IRB) approval: Institutional Review Board of Ewha Womans University Hospital (EUMC 2015-05-003-003). Clinical trials registration number: Clinical Research Information Service (CRIS, registration number: KCT0002288; RCT URL: https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=7309)KEY WORDS: Epidural injections, epidural space, low back pain, radiating pain, disability evaluation, steroids, local anesthetics, intervertebral disc disease, spinal stenosis.
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Low back pain is a significant problem for school-aged athletes. Although some risk factors relating to sports activities have been reported, the effect of lifestyles on low back pain in school-aged athletes is not clear. The purpose of this study was to elucidate the association between lifestyles, such as wake-up time, bedtime, sleeping time, and TV-viewing or video-game-playing time per day and low back pain of school-aged athletes. ⋯ Unhealthy life-style choices, such as late bedtimes, short sleeping time, and longtime video-game playing, were associated with low back pain in school-aged athletes.