European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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To report evidence of chronic physical illnesses, mental health disorders, and psychological features as potential risk factors for back pain in children, adolescents, and young adults. ⋯ Psychological features are the most likely risk factors for back pain in young people. Several other factors were associated with back pain, but their potential as risk factors was unclear due to risk of bias. Additional high-quality research is needed to better elucidate these relationships. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
Defining and measuring imaging appropriateness in low back pain studies: a scoping review.
Patients with low back pain (LBP) rarely have serious underlying pathology but frequently undergo inappropriate imaging. A range of guidelines and red flag features are utilised to characterise appropriate imaging. This scoping review explores how LBP imaging appropriateness is determined and calculated in studies of primary care practice. ⋯ Greater clarity is needed on how we define and measure imaging appropriateness for LBP, which also accounts for the problem of failing to image when indicated. An internationally agreed methodology for imaging appropriateness studies would ultimately lead to an improvement in the care delivered to patients. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
Reduction mammoplasty and back pain: a systematic review and meta-analysis.
There is anecdotal evidence that many patients who undergo reduction mammoplasty (RM) procedures, to relieve symptoms of large breasts, also report improvement in existing back pain. Given how important back pain is as a healthcare burden, the literature which explores the relationship between RM and back pain is sparse. Thus, we aimed to appraise whether such a correlation exists, through systematic review and meta-analysis. ⋯ Although cursory, the evidence gleaned suggests that RM reduces the prevalence of back pain in patients with large breasts. Furthermore, we highlight the scarcity of studies investigating whether RM is at the clinical threshold of efficacy in treating back pain. Although the evidence is insufficient for recommending RM as a management option aimed at treating back pain, this review does identify the need for prospective data looking at back pain metrics as a specific outcome measure before and after reduction mammoplasty.
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To examine the strength of evidence available for multiple facet joint injections (FJIs) and medial branch blocks (MBBs), and to report on the variations in the NHS England framework using the getting it right first time (GIRFT) data. ⋯ There is a paucity of levels I and II evidence available for the efficacy of multiple FJIs and MBBs in treating low back pain. GIRFT data show a high degree of variation in the use of multiple FJIs, which would not be supported by the literature. These slides can be retrieved under Electronic Supplementary Material.
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To study the various pain assessment tools based on their psychometric properties and ease of use. ⋯ Based on psychometric properties and ease of use, the best tools for LBP seem to be RMDQ/ODI (among LBP-specific tools), BPI (among generic tools), SF-MPQ-2/NPS (for neuropathic LBP), PAINAD (for cognitively impaired patients), and unidimensional tools and SF-MPQ-2 (for acute pain). Overall, BPI seems to be a tool that can be relied upon the most. These slides can be retrieved under Electronic Supplementary Material.