Articles: low-back-pain.
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Meta Analysis
The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis.
Understanding the clinical course of low back pain is essential to informing treatment recommendations and patient stratification. Our aim was to update our previous systematic review and meta-analysis to gain a better understanding of the clinical course of acute, subacute and persistent low back pain. ⋯ PROSPERO - CRD42020207442.
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Multicenter Study
Effectiveness and safety of tendon-bone-setting in postpartum women with sacroiliac joint pain: A retrospective multicenter study.
Sacroiliac joint (SIJ) pain leads to abnormal joint loading, and is a key risk factor for joint degeneration. This study aimed to determine the effect of tendon-bone-setting on postpartum women with SIJ pain. Multicenter retrospective review of medical records and electroencephalography reports in 10 academic medical centers. 328 postpartum women with sacroiliac joint pain were divided into 2 groups according to the methods of therapy. ⋯ Also, the cumulative incidence of pain relief at 24 months in the group (A) was greater compared with the group (B) as determined by Kaplan-Meier analysis (P < .05). Interestingly, none serious adverse event for the participants was reported. Tendon-Bone-Setting is effective and safe in treating sacroiliac joint pain for the postpartum women patients in the short and long terms through decreasing pain sensitivity and intensity, as well as improving functional ability.
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Background and Objectives: Spinal anesthesia is widely used in various types of surgery. However, several complications can occur afterward. This study aimed to identify differences in the incidence of anesthesia-related complications according to the approach methods (midline versus paramedian) for landmark-based spinal anesthesia. ⋯ The incidence rates of PDPH were 5.9% and 10.4% in the paramedian and midline approach groups, respectively. The pooled effect size revealed that the incidence of PDPH (OR: 0.43, 95% CI [0.22-0.83]; p = 0.01; I2 = 53%) and LBP (OR: 0.27, 95% CI [0.16-0.44]; p < 0.001; I2 = 16%) decreased, and the success rate in the first attempt was higher (OR: 2.30, 95% CI [1.36-3.87]; p = 0.002; I2 = 35%) with the paramedian than with the midline approach. Conclusions: Paramedian spinal anesthesia reduced PDPH and LBP and increased the success rate of the first attempt.
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The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted. In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes. ⋯ Across disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial.
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Primary care physicians (PCPs) often face a complex intersection of patient expectations, evidence, and policy that influences their care recommendations for acute low back pain (aLBP). The purpose of this study was to elucidate patterns of PCP orders for patients with aLBP, identify the most common patterns, and describe patient clinical and demographic characteristics associated with patterns of aLBP care. ⋯ Guideline discordant orders such as steroids and NSAIDS are often combined with guideline recommended orders such as physical therapy. Further defining patient, clinician, and health care setting characteristics associated with discordant care would inform targeted efforts for deimplementation initiatives.