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Latest & greatest articles for low back pain
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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
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
The clinical utility of lumbar discography for assessing lowbackpain: impact on patient management and health outcomes The clinical utility of lumbar discography for assessing lowbackpain: impact on patient management and health outcomes The clinical utility of lumbar discography for assessing lowbackpain: impact on patient management and health outcomes HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. The clinical utility of lumbar discography for assessing lowbackpain: impact on patient management and health outcomes. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Rationale: Discography evaluates the suspected culprit discs with abnormal morphology and, as a control, normal discs. In theory, the combination of imaging that demonstrates disc degeneration or internal disc
Facet-joint injections for non-specific lowbackpain: a feasibility RCT Facet-joint injections for non-specific lowbackpain: a feasibility RCT Facet-joint injections for non-specific lowbackpain: a feasibility RCT Snidvongs S, Taylor R S, Ahmad A, Thomson S, Sharma M, Farr A, Fitzsimmons D, Poulton S, Mehta V & Langford R Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Snidvongs S, Taylor R S, Ahmad A, Thomson S, Sharma M, Farr A, Fitzsimmons D, Poulton S, Mehta V & Langford R. Facet-joint injections for non-specific lowbackpain: a feasibility RCT. Health Technology Assessment 2017; 21(74) Authors' objectives To assess the feasibility of carrying out a definitive study to evaluate the clinical effectiveness and cost-effectiveness of lumbar facet-joint injections compared with a sham procedure in patients with non-specific low
In adults with chronic lowbackpain, are core stability exercises more effective in improving function and decreasing pain compared to a general exercise programme? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: 9/1/2018 CAT Lead: Lucy Thomas Date CAT completed: 9/1/2018 Email: firstname.lastname@example.org Date CAT to be reviewed: January 2021 Review CAT Clinical bottom line In adults with chronic lowbackpain core stability exercises (...) are not superior to other forms of exercise in improving function and decreasing pain. Clinical practice should aim to promote general exercise. Why is this important? Lowbackpain is a common condition which is treated in outpatient physiotherapy departments. Current evidence suggests that no single exercise is superior to another. Core stability exercises are among the most commonly used interventions in the treatment of backpain but could the use of a more general approach to exercise be just as effective
Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic lowbackpain: protocol of a randomised controlled trial. Chronic lowbackpain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for backpain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE (...) ) and back endurance-resistance exercises (BERE) may improve backpain and function performance. However, it is still unclear which type of exercise is more effective for the treatment of CLBP in athletes.To compare the efficacy of LMSE versus BERE in athletes with CLBP.The study is a 2-arm, prospectively registered, randomised controlled trial.The physical therapy clinical and biomechanics laboratory of the UNOPAR University.32 male athletes with CLBP, age between 18 and 40 years old, recruited from
Home-based exercise therapy for treating non-specific chronic lowbackpain. To evaluate pain, functional capacity, and quality of life of patients with non-specific chronic lowbackpain, after home-based exercise therapy with different kinds of supervision.Thirty individuals of both gender, between 18 and 65 years old, performed the proposed exercises three times a week, for eight weeks. Group A (N = 17) performed the exercises after a single supervised session. Group B (N = 13 (...) significant improvement after 8 weeks (p <0.05). There was no difference when comparing groups A and B (p >0,05).Home-based exercise therapy, when performed in a period of eight weeks, using the booklet, was effective for improving level of pain, functional capacity, and quality of life in patients with non-specific chronic lowbackpain. The weekly supervision did not significantly influence the final outcome between the groups.
Discogenic lowbackpain Discogenic lowbackpain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Discogenic lowbackpain Last reviewed: February 2019 Last updated: January 2019 Summary Magnetic resonance imaging is the imaging study of choice for degenerative disc disease due to its unique detail on the representation of the disc status. Other tests may include plain radiographs, computed tomography scanning (...) , or provocative discography. Non-surgical treatments include lifestyle measures, followed by the judicious use of medications, physiotherapy, and therapeutic needling procedures. Surgical treatment includes decompression of neural structures and, in selected patients, a fusion of the motion segment. Definition A complex, multi-factorial, clinical condition characterised by lowbackpain with or without the concurrence of radicular lower limb symptoms in the presence of radiologically-confirmed degenerative
A Randomized, Double-Blind, Placebo-Controlled Trial of Naproxen With or Without Orphenadrine or Methocarbamol for Acute LowBackPain In US emergency departments (EDs), patients with lowbackpain are often treated with nonsteroidal anti-inflammatory drugs and muscle relaxants. We compare functional outcomes among patients randomized to a 1-week course of naproxen+placebo versus naproxen+orphenadrine or naproxen+methocarbamol.This was a randomized, double-blind, comparative effectiveness trial (...) conducted in 2 urban EDs. Patients presenting with acute, nontraumatic, nonradicular lowbackpain were enrolled. The primary outcome was improvement on the Roland-Morris Disability Questionnaire (RMDQ) between ED discharge and 1 week later. All patients were given 14 tablets of naproxen 500 mg, to be used twice a day, as needed for lowbackpain. Additionally, patients were randomized to receive a 1-week supply of orphenadrine 100 mg, to be used twice a day as needed, methocarbamol 750 mg, to be used
Backpain - low (without radiculopathy) Backpain - low (without radiculopathy) - NICE CKS Share Backpain - low (without radiculopathy): Summary Lowbackpain affects the lumbosacral area of the back, between the bottom of the ribs and the top of the legs. It affects around one third of the adult population each month. In most people, lowbackpain is non-specific and serious specific causes are rare. Complications include: Development of chronicity and depression. Disability and loss (...) of employment. Non-specific lowbackpain is often a chronic problem in which periods of little pain or disability are interrupted by acute episodes of severe pain. In people with lowbackpain: Serious spinal pathology, inflammatory features, and sciatica should be excluded. Non-specific lowbackpain should be diagnosed in people with lowbackpain which varies with posture and is exacerbated by movement. X-rays of the back should not routinely be requested to diagnose non-specific lowbackpain
Treatment of LowBackPain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results Even though modern concepts of disease management of unspecific lowbackpain (LBP) postulate active participation of patients, this strategy is difficult to adapt unless multidisciplinary pain therapy is applied. Recently, mobile health solutions have proven to be effective aides to foster self-management of many diseases.The objective of this paper was to report on the retrospective short-term (...) backpain according to current guidelines.Data of 180 users were available. The mean age of the users was 33.9 years (SD 10.9). Pain levels decreased from baseline NRS 4.8 to 3.75 for all users at the end of the observation period. Users who completed 4, 8, or 12 weeks showed an even more pronounced decrease in pain level NRS (baseline 4.9 [SD 1.7] versus 3.6 [SD 1.5] at 4 weeks; baseline 4.7 [SD 1.8] versus 3.2 [SD [2.0] at 8 weeks; baseline 4.6 [SD 2.2] versus 2.6 [SD 2.0] at 12 weeks
Cost-effectiveness of Mindfulness-based Stress Reduction Versus Cognitive Behavioral Therapy or Usual Care Among Adults With Chronic LowBackPain Economic evaluation alongside a randomized trial of cognitive-behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) versus usual care alone (UC) for chronic lowbackpain (CLBP).To determine 1-year cost-effectiveness of CBT and MBSR compared to 33 UC.CLBP is expensive in terms of healthcare costs and lost productivity. Mind-body (...) interventions have been found effective for backpain, but their cost-effectiveness is unexplored.A total of 342 adults in an integrated healthcare system with CLBP were randomized to receive MBSR (n = 116), CBT (n = 113), or UC (n = 113). CBT and MBSR were offered in 8-weekly 2-hour group sessions. Cost-effectiveness from the societal perspective was calculated as the incremental sum of healthcare costs and productivity losses over change in quality-adjusted life-years (QALYs). The payer perspective only
Lowbackpain and radicular pain: development of a clinical pathway 2017 www.kce.fgov.be KCE REPORT 295 LOWBACKPAIN AND RADICULAR PAIN: DEVELOPMENT OF A CLINICAL PATHWAY 2017 www.kce.fgov.be KCE REPORT 295 HEALTH SERVICES RESEARCH LOWBACKPAIN AND RADICULAR PAIN: DEVELOPMENT OF A CLINICAL PATHWAY PASCALE JONCKHEER, ANJA DESOMER, BART DEPREITERE, ANNE BERQUIN, MICHAEL BRUNEAU, WENDY CHRISTIAENS, ELLEN COECKELBERGHS, CHRISTOPHE DEMOULIN, PIERRE DUQUENNE, PATRICE FORGET, VIRGINIE FRASELLE, LODE (...) GODDERIS, GUY HANS, DAVY HOSTE, LAURENCE KOHN, PHILIPPE MAIRIAUX, EVERARD MUNTING, HENRI NIELENS, THOMAS ORBAN, THIERRY PARLEVLIET, BENOÎT PIROTTE, KOEN VAN BOXEM, JOHAN VAN LERBEIRGHE, PATRICK VAN SCHAEYBROECK, PETER VAN WAMBEKE, JAN VAN ZUNDERT, JACQUES VANDERSTRAETEN, KRIS VANHAECHT DOMINIQUE VERHULST COLOPHON Title: Lowbackpain and radicular pain: development of a clinical pathway Authors: Pascale Jonckheer (KCE), Anja Desomer (KCE), Bart Depreitere (UZ Leuven), Anne Berquin (Cliniques