Spine
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Randomized Controlled Trial Clinical Trial
Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints.
Prospective randomized study to compare the efficacy of facet joint injection with lidocaine and facet joint injection with saline in two groups of patients with low back pain, with and without clinical criteria that were determined in a previous study to implicate the facet joint as the primary source of the pain. ⋯ A set of five clinical characteristics can be used in randomized studies to select lower back pain that will be well relieved by facet joint anesthesia. These characteristics should not, however, be considered as definite diagnostic criteria of lower back pain originating from facet joints.
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Randomized Controlled Trial Comparative Study Clinical Trial
One-year follow-up comparison of the cost and effectiveness of chiropractic and physiotherapy as primary management for back pain. Subgroup analysis, recurrence, and additional health care utilization.
A randomized trial was conducted in which patients with back and neck pain, visiting a general practitioner, were allocated to chiropractic or physiotherapy. ⋯ Effectiveness and costs of chiropractic or physiotherapy as primary treatment were similar for the total population, but some differences were seen according to subgroups. Back problems often recurred, and additional health care was common. Implications of the result are that treatment policy and clinical decision models must consider subgroups and that the problem often is recurrent. Models must be implemented and tested.
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Randomized Controlled Trial Clinical Trial
The ability of lumbar medial branch blocks to anesthetize the zygapophysial joint. A physiologic challenge.
Randomized, controlled, single blinded study. ⋯ There was a significant effect of 2% lidocaine (versus saline) medial branch injections on anesthetization of the zygapophysial joint when venous uptake was avoided during these injections. When properly performed, lumbar medial branch blocks successfully inhibit pain associated with capsular distention of the lumbar zygapophysial joints at a rate of 89%.