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Latest & greatest articles for low back pain
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Diagnosis and Treatment of LowBackPainLowBackPain -- Clinical Recommendation Welcome Search Search Specify your search AAFP.org Patient Care Clinical Practice Guideline LowBackPain Diagnosis and Treatment of LowBackPain (Endorsed, April 2017) The guideline, Noninvasive Treatments for Acute, Subacute, and Chronic LowBackPain , was developed by the American College of Physicians and was endorsed by the American Academy of Family Physicians. Key Recommendations Nonpharmacologic (...) treatment, including superficial heat, massage, acupuncture, or spinal manipulation, should be used initially for most patients with acute or subacute lowbackpain, as they will improve over time regardless of treatment. When pharmacologic treatment is desired, nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants should be used. Nonpharmacologic treatment, including exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor
Manipulating Research for Spinal Manipulative Therapy for LowBackPain Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,500 family physicians, family medicine residents and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education, and primary care research (...) . www.acfp.ca February 21, 2017 Manipulating Research for Spinal Manipulative Therapy for LowBackPain Clinical Question: Is spinal manipulative therapy (SMT) effective for lowbackpain (LBP)? Bottom Line: Research around SMT is poor, consistently inconsistent, and almost impossible to interpret. Likely no reliable effects in acute LBP, but possible small effects in chronic LBP, at best improved pain ( =0.9 points out of 10) and recovery (for one in ~11 patients at one month) but two thirds of comparisons
Percutaneous epidural neurolysis and endoscopic neurolysis for the treatment of chronic lowbackpain Percutaneous epidural neurolysis and endoscopic neurolysis for the treatment of chronic lowbackpain Percutaneous epidural neurolysis and endoscopic neurolysis for the treatment of chronic lowbackpain Brito V, Ciapponi A, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, López A, Rey-Ares L 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 Brito V, Ciapponi A, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, López A, Rey-Ares L. Percutaneous epidural neurolysis and endoscopic neurolysis for the treatment of chronic lowbackpain. Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Informe de Respuesta Rapida No. 483. 2016 Authors' conclusions Evidence of moderate
Ibuprofen plus paracetamol versus ibuprofen in acute lowbackpain: a randomized open label multicenter clinical study. to estimate whether combination of ibuprofen and paracetamol is more effective than ibuprofen in monotherapy, in the treatment of acute lowbackpain.80 adult patients with acute lowbackpain were randomized into two subgroups. In the first subgroup, 40 patients were treated with ibuprofen 400mg three times a day (TID), whilst patients in the second subgroup (n=40) were (...) intolerability.compared to ibuprofen monotherapy, combination of ibuprofen and paracetamol may provide faster and longer analgesia in patients with acute lowbackpain, with equally favorable effect on mobility and functional ability and similar tolerability.
Do rocker-sole shoes influence postural stability in chronic lowbackpain? A randomised trial. People with chronic lowbackpain (CLBP) demonstrate greater postural instability compared with asymptomatic individuals. Rocker-sole shoes are inherently unstable and may serve as an effective balance training device. This study hypothesised that wearing rocker-sole shoes would result in long-term improvement in barefoot postural stability in people with CLBP.20 participants with CLBP were
Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific lowbackpain: study protocol of a randomised controlled trial (NURSE-RCT). Nursing personnel have high risk for incidence of lowbackpain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain (...) , disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating backpain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group.The design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12
Non-specific lowbackpain. Non-specific lowbackpain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of lowbackpain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific lowbackpain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists (...) of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of lowbackpain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids
The Diagnostic Accuracy of Gluteal Trigger Points to Differentiate Radicular From Nonradicular LowBackPainLowbackpain (LBP) is highly prevalent and costly to the society. Previous studies have shown an association between radicular LBP and trigger points (TrPs) in the superior-lateral quadrant of the gluteal area (GTrP). The objective of current study was to evaluate the diagnostic value of GTrP to predict nerve root involvement among patients with LBP.In a prospective, diagnostic accuracy
Back schools for acute and subacute non-specific low-backpain. Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating people with low-backpain (LBP). However, the content of back schools has changed and appears to vary widely today. In this review we defined back school as a therapeutic programme given to groups of people, which includes both education and exercise. This is an update of a Cochrane review first published in 1999 (...) a placebo (or sham or attention control) or another treatment (physical therapies, myofascial therapy, joint manipulations, advice) on pain, disability, work status and adverse events at short-term, intermediate-term and long-term follow-up. There is very low quality evidence that shows a statistically significant difference between back schools and a placebo (or sham or attention control) for return to work at short-term follow-up in favour of back school. Very low quality evidence suggests that back
The Effectiveness of Mechanical Traction Among Subgroups of Patients With LowBackPain and Leg Pain: A Randomized Trial Randomized clinical trial. Background The recommended initial management strategy for patients with lowbackpain and signs of nerve root compression is conservative treatment, but there is little evidence to guide the most appropriate management strategy. Preliminary research suggests that a treatment protocol of mechanical traction and extension-oriented exercises may (...) be effective, particularly in a specific subgroup of patients.To examine the effectiveness of mechanical traction in patients with lumbar nerve root compression and within a predefined subgroup.One hundred twenty patients with lowbackpain with nerve root compression were recruited from physical therapy clinics. Using predefined subgrouping criteria, patients were stratified at baseline and randomized to receive an extension-oriented treatment approach with or without the addition of mechanical traction
Noninvasive treatments for lowbackpain Noninvasive treatments for lowbackpain Noninvasive treatments for lowbackpain Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt E 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 Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R (...) , Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt E. Noninvasive treatments for lowbackpain. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 169. 2016 Authors' objectives Lowbackpain is common, and many pharmacological and nonpharmacological therapies are available. This review examines the evidence on the comparative benefits and harms of noninvasive treatments for lowbackpain. Authors' conclusions A number of pharmacological
Frequency of sacroiliitis among patients with lowbackpain Sacroiliitis is one of the important symptoms in patients attending infectious diseases and rheumatology clinics. Some patients with sacroiliitis are asymptomatic, and some have unspecific symptoms. The aim of this study was to determine the frequency of sacroiliitis causes among patients attending Shahid Sadoughi's infectious disease and rheumatology clinics.In this study, we evaluated patients attending Shahid Sadoughi rheumatology
Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on BackPain and Functional Limitations in Adults With Chronic LowBackPain: A Randomized Clinical Trial. Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic lowback pain.To evaluate the effectiveness for chronic lowbackpain of MBSR vs cognitive behavioral therapy (CBT) or usual care.Randomized, interviewer-blind, clinical trial (...) in an integrated health care system in Washington State of 342 adults aged 20 to 70 years with chronic lowbackpain enrolled between September 2012 and April 2014 and randomly assigned to receive MBSR (n = 116), CBT (n = 113), or usual care (n = 113).CBT (training to change pain-related thoughts and behaviors) and MBSR (training in mindfulness meditation and yoga) were delivered in 8 weekly 2-hour groups. Usual care included whatever care participants received.Coprimary outcomes were the percentages
Core stability versus conventional exercise for treating non-specific lowbackpain. BestBets: Core stability versus conventional exercise for treating non-specific lowbackpain. Core stability versus conventional exercise for treating non-specific lowbackpain. Report By: John Davin and Michael Callaghan. - 1st Team Rehabilitation Physiotherapist. Head of Therapies Institution: Manchester United Football Club Date Submitted: 9th December 2015 Date Completed: 17th February 2016 Last Modified (...) : 17th February 2016 Status: Green (complete) Three Part Question In [patients presenting with lowbackpain] is [a core stability programme more effective than conventional exercise based therapy] at [decreasing pain, increasing mobility and returning to play]. Clinical Scenario A 24 year old male presents with chronic lowbackpain. Investigations have ruled out any serious disc, joint or bony pathology. Current opinion advocates core stability as the ‘go to’ treatment for this non-specific pain
Noninvasive Treatments for LowBackPain Noninvasive Treatments for LowBackPain: Current State of the Evidence Focus of This Summary This review examines the evidence on the comparative benefits and harms of noninvasive treatments for acute, subacute, and chronic lowbackpain from 156 studies that were published before April 2015. Excluded from the review were studies conducted among patients with lowbackpain related to cancer, infection, inflammatory arthropathy, high-velocity trauma (...) , or fracture or lowbackpain associated with severe or progressive neurological deficits. The full report, listing all studies, is available at www.effectivehealthcare.ahrq.gov/low-back-pain. This summary is provided to assist in informed clinical decisionmaking. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. Conclusions Several interventions for lowbackpain are associated with small-to-moderate, primarily short-term effects on pain versus