Articles: low-back-pain.
-
Long-term low back pain is associated with multiple challenges to a person's identity and social position. Despite efforts to understand the challenges of low back pain, recovery remains a major problem both personally and socially. This indicate a need for a different approach. Although personal stories have been used to extend knowledge of issues that relate to low back pain, they also make it possible to learn about how people understand themselves and their lives. As such, analysis of narratives may provide further insights into people's coping processes and novel insights about how best to support them. ⋯ Health professionals can play an important role in low back pain sufferers' configuration of meaningful narratives that help in coping with pain and learning about the relationship between pain and everyday life.
-
Although lumbar spinal stenosis often presents as a degenerative condition (degenerative stenosis [DS]), some patients present with symptoms from lifelong narrowing of the spinal canal. These patients have congenital stenosis (CS) and present with symptoms of stenosis at a younger age. Patients with CS often have a distinct pathophysiology with fewer degenerative changes but present with multilevel involvement. In the setting of neurologic symptoms, decompression alone while preserving stability has been proposed for both patient populations. ⋯ Patients with CS and patients with DS respond well to decompression alone, without a supplemental fusion, despite differences in pain experience and presentation. The localization of pathology requiring decompression is similar. The patients with DS were more susceptible to require another operation resulting in a fusion, which confirms the theory that initial microinstability can progress in DS, but is likely not part of the disease process in CS. At just over 2 years after decompression, patients with CS may not need to be treated by a fusion in the setting of lower back pain; however, longer-term follow up is necessary to further assess these outcomes.
-
The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the management of low back pain. The aim of this study was to translate the PABS-PT into Norwegian from the original 36-item Dutch version and to examine its dimensionality and internal consistency. ⋯ The Norwegian version of the PABS-PT appears to be equivalent to the original Dutch version, showing a similar structure and internal consistency. The two factors accounted for low explained variance, which may be indicative for problematic construct validity. Psychometric properties and usefulness will be further examined. Copyright © 2016 John Wiley & Sons, Ltd.
-
Editorial Comment
Sham opioids relieve multidimensional aspects of chronic back pain.
-
Meta-epidemiological studies examining the influence of methodological characteristics, such as allocation concealment and intention-to-treat analysis have been performed in a large number of healthcare areas. However, there are no studies investigating these characteristics in physical therapy interventions for patients with low back pain. The aim of this study is to investigate the influence of allocation concealment and the use of intention-to-treat analysis on estimates of treatment effects of physical therapy interventions in low back pain clinical trials. ⋯ International Prospective Register of Systematic Reviews (CRD42016052347).