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Latest & greatest articles for low back pain
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Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating LowBackPain: Literature Review With Meta-analysis Study Design Literature review with meta-analysis. Background The McKenzie Method of Mechanical Diagnosis and Therapy (MDT), a classification-based system, was designed to classify patients into homogeneous subgroups to direct treatment. Objectives To examine the effectiveness of MDT for improving pain and disability in patients with either acute (less than (...) 12 weeks in duration) or chronic (greater than 12 weeks in duration) lowbackpain (LBP). Methods Randomized controlled trials examining MDT in patients with LBP were identified from 6 databases. Independent investigators assessed the studies for exclusion, extracted data, and assessed risk of bias. The standardized mean difference (SMD) and 95% confidence interval were calculated to compare the effects of MDT to those of other interventions in patients with acute or chronic LBP. Results
Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic LowBackPain Chronic lowbackpain (CLBP) is highly prevalent in older adults, leading to functional decline.The objective of this study was to evaluate physical activity (PA) only and PA plus cognitive-behavioral therapy for pain (CBT-P) among older adult veterans with CLBP.This study was a pilot randomized trial comparing a 12-week telephone-supported PA-only intervention group (PA
Effects of spinal manipulation and pain education on pain in patients with chronic lowbackpain: a protocol of randomized sham-controlled trial Lowbackpain (LBP) has more than doubled in the last 20 years, probably influenced by biopsychosocial factors. Noninvasive treatments have been applied in individuals with chronic nonspecific LBP as spinal manipulation and pain education. However, the neurophysiological effects of these treatments are not clear. The aim of this research is to verify (...) the pain control, functional and neurophysiological effects of spinal manipulation, and pain education in individuals with chronic nonspecific LBP.This research is an assessor and subject blinded, 2-arm, randomized sham-controlled trial and will be conducted at Governador Celso Ramos Hospital, Florianópolis, Brazil. One hundred and twenty-eight individuals with chronic nonspecific LBP will be recruited for this study. Individuals will be randomly allocated into one of the two groups: (1) spinal
Is Vitamin D Supplementation Effective for LowBackPain? A Systematic Review and Meta-Analysis Lowbackpain (LBP) is the leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBP and are prompting researchers to investigate alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti (...) , regardless of the type of LBP or vitamin D supplementation. Until well-designed and adequately powered clinical trials suggest otherwise, the prescription of vitamin D for LBP cannot be recommended. PROSPERO Registration No: CRD42016046874. www.crd.york.ac.uk/PROSPERO/display_record.asp?ID = CRD42016046874.Vitamin D, lowbackpain, chronic lowbackpain, alfacalcidol, osteoporosis, vertebral fractures, serum 25-hydroxyvitamin D, systematic review.
The views and experiences of Malaysian primary care doctors in managing patients with chronic lowbackpain: a qualitative study Chronic lowbackpain (CLBP) is a common and often difficult to treat condition in the primary care setting. Research involving in-depth exploration on the views and experiences faced by primary care doctors in managing patients with CLBP in Malaysia is limited.To explore the primary care practitioners' views and experiences in managing patients with CLBP.A
A commonly used treatment does not improve chronic lowbackpain A commonly used treatment does not improve chronic lowbackpain Discover Portal Discover Portal A commonly used treatment does not improve chronic lowbackpain Published on 7 November 2017 doi: This trial found that destroying nerves that take pain signals to the brain using heat (radiofrequency denervation) did not improve pain, function or a sense of “recovery”. The treatment was used alongside exercise and was a variation (...) of the technique commonly used in the UK. In this large study, it was compared to exercise alone. Lowbackpain is usually short-lived, but some people develop long-term backpain which can negatively impact their lives. NICE recommends exercise, pain relief and self-management to cope with pain. If these treatments are not effective and pain is severe, then more intensive options, such as radiofrequency denervation can be considered. These findings suggest that this technique of radiofrequency denervation
Two nerve drugs are not suitable for treating long-term lowbackpain Two nerve drugs are not suitable for treating long-term lowbackpain Discover Portal Discover Portal Two nerve drugs are not suitable for treating long-term lowbackpain Published on 5 December 2017 doi: The drugs gabapentin and pregabalin (gabapentinoids) were found not to help lower backpain that had lasted more than three months. Gabapentin gave no benefit compared with placebo, while pregabalin was less effective than (...) other painkillers. Both were associated with several side effects, such as dizziness. Long-term lowbackpain without clear cause is very common. It causes considerable loss of productivity and places a high demand on the healthcare service. It is difficult to treat, and people often get limited relief from simple painkillers, causing practitioners to consider alternative options. This review gathered eight trials looking at gabapentinoids for adults with long-term lower backpain. The evidence
Cognitive behavioural therapy may help people with persistent lowbackpain Cognitive behavioural therapy may help people with persistent lowbackpain Discover Portal Discover Portal Cognitive behavioural therapy may help people with persistent lowbackpain Published on 14 October 2015 doi: This NIHR-funded systematic review aimed to assess the effectiveness of talking therapies in improving outcomes for people with non-specific lowbackpain. It found that cognitive behavioural therapies (...) people experiencing lower backpain and the risk of ongoing problems for those with recent symptoms. However, the review included many different interventions, many of which were not properly described, which limit the uptake and implementation of findings in practice. It is likely that a substantial increase in NHS capacity would be needed to deliver cognitive behavioural therapies for the many people with persistent lowbackpain. This may be important though, as the provision of programmes
Preferences for Web-Based Information Material for LowBackPain: Qualitative Interview Study on People Consulting a General Practitioner Information on self-management, including addressing people's fears and concerns, are core aspects of managing patients with lowbackpain (LBP). Web apps with patient information may be used to extend patient-physician consultations and encourage self-management outside of the consultation room. It is, however, important to identify the end users' needs
Effects and underlying mechanisms of unstable shoes on chronic lowbackpain: a randomized controlled trial To investigate the effects that wearing unstable shoes has on disability, trunk muscle activity, and lumbar spine range of motion (ROM) in patients with chronic lower backpain (CLBP).Randomized controlled trial.Orthopedic Surgery Service.We randomized 40 adults with nonspecific CLBP either to an unstable shoes group ( n = 20) or to the control group ( n = 20).The participants (...) in the unstable shoes group were advised to wear these shoes for a minimum of six hours a day for four weeks. Control group participants were asked to continue wearing their regular shoes.Our primary outcome was measurement of back-related dysfunction, assessed using the Roland-Morris Disability Questionnaire. Secondary outcomes included changes in electromyographic (EMG) activity of erector spinae (ES), rectus abdominis (RA), internus obliquus (IO), and externus obliquus (EO) muscles, and changes in lumbar
What lowbackpain is and why we need to pay attention. Lowbackpain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by lowbackpain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Lowbackpain is now the leading cause (...) of disability worldwide. For nearly all people with lowbackpain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting lowbackpain. Disabling lowbackpain is over-represented among people with low socioeconomic status. Most people
Prevention and treatment of lowbackpain: evidence, challenges, and promising directions. Many clinical practice guidelines recommend similar approaches for the assessment and management of lowbackpain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms (...) . Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related
A systematic review and meta-analysis of the reliability and validity of sensorimotor measurement instruments in people with chronic lowbackpain. Deficits in the sensorimotor system and its peripheral and central processing of the affected body part might be a contributing factor to chronic lowbackpain (CLBP). Hence, sensorimotor assessment is important. Valid and reliable sensorimotor measurement instruments are needed.To investigate the reliability and validity of sensorimotor measurement (...) instruments for people with chronic lowbackpain (CLBP).Systematic review and meta-analysis.The review was undertaken using the COSMIN guidelines. Databases were searched for studies investigating the clinimetric properties of sensorimotor tests in people with CLBP. The methodological study quality was rated by two independent reviewers using the COSMIN 4-point rating checklist.Ten studies were included covering six sensorimotor measurement instruments with findings for reliability/measurement error
Response to the Letter to the Editor on 'The effectiveness of technology-supported exercise therapy for lowbackpain: A systematic review.' 29543599 2018 09 20 1537-7385 97 10 2018 Oct American journal of physical medicine & rehabilitation Am J Phys Med Rehabil Response to the Letter to the Editor on "The Effectiveness of Technology-Supported Exercise Therapy for LowBackPain: A Systematic Review". e96-e97 10.1097/PHM.0000000000000922 Matheve Thomas T Rehabilitation Research Center (REVAL
Exercise Therapy for LowBackPain: A Systematic Review. 29543600 2018 09 20 1537-7385 97 10 2018 Oct American journal of physical medicine & rehabilitation Am J Phys Med Rehabil Exercise Therapy for LowBackPain: A Systematic Review. e96 10.1097/PHM.0000000000000921 Kawada Tomoyuki T Department of Hygiene and Public Health Nippon Medical School Tokyo, Japan. eng Journal Article United States Am J Phys Med Rehabil 8803677 0894-9115 2018 3 16 6 0 2018 3 16 6 0 2018 3 16 6 0 ppublish 29543600
The effects of walking intervention in patients with chronic lowbackpain: A meta-analysis of randomized controlled trials. The aim of this meta-analysis of randomized controlled trials was to gain insight into the effectiveness of walking intervention on pain, disability, and quality of life in patients with chronic lowbackpain (LBP) at post intervention and follow ups.Six electronic databases (PubMed, Science Direct, Web of Science, Scopus, PEDro and The Cochrane library) were searched (...) from 1980 to October 2017. The following keywords were used: Walk* or Pedometer* or Accelerometer* or Treadmill* paired with "Backpain", "Lowbackpain", "Chronic lowbackpain", "LBP", or "Backache". Randomized controlled trials in patients with chronic LBP were included if they compared the effects of walking intervention to non-pharmacological interventions. Pain, disability, and quality of life were the primary health outcomes.Nine studies were suitable for meta-analysis. Data was analyzed
Implication of Two Different Doses of Intradiscal Ozone-Oxygen Injection upon the Pain Alleviation in Patients with LowBackPain: A Randomized, Single-Blind Study Lowbackpain (LBP) is mostly induced by disc herniation (DH) or degeneration and has a burden upon social activity and economical aspects of life. An abundance of medical and surgical interventions have evolved to resolve this problem, but one of the newly introduced techniques, which is the minimally invasive, low cost ozone-oxygen (...) ₃-O₂ mixture is a very valuable maneuver in the reduction of DH size and improvement of pain quality, with either ozone concentrations of 40 µg/mL or 30 µg/mL.Low backpain, ozone, disc herniation.
Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic LowBackPain: A Single-Blind Randomized Controlled Trial To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic lowbackpain (CLBP).Single-blind randomized controlled trial.Private clinic and university.Patients with CLBP for ≥6 months (N=56).Participants were randomized to receive either a TE program consisting of motor control, stretching (...) , and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants.The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1- and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia