The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial
Recovery of motor deficit accompanying sciatica--subgroup analysis of a randomized controlled trial.
In patients with sciatica due to a lumbar disc herniation, it is generally recommended to reserve surgical treatment for those who suffer from intolerable pain or those who demonstrate persistent symptoms after conservative management. Controversy exists about the necessity of early surgical intervention for those patients that have an additional motor deficit. ⋯ Early surgery resulted in a faster recovery of motor deficit accompanying sciatica compared with prolonged conservative treatment but the difference was no longer significant during the final follow-up examination at 1 year.
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Randomized Controlled Trial
Spinal manipulative therapy and exercise for seniors with chronic neck pain.
Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors. ⋯ SMT with HE resulted in greater pain reduction after 12 weeks of treatment compared with both supervised plus HE and HE alone. Supervised exercise sessions added little benefit to the HE-alone program.
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Randomized Controlled Trial
Associations between physical therapy and long-term outcomes for individuals with lumbar spinal stenosis in the SPORT study.
A period of nonsurgical management is advocated before surgical treatment for most patients with lumbar spinal stenosis. Currently, little evidence is available to define optimal nonsurgical management. Physical therapy is often used, however its use and effectiveness relative to other nonsurgical strategies has not been adequately explored. ⋯ Many patients with lumbar spinal stenosis pursuing conservative management receive physical therapy. Using physical therapy was associated with reduced likelihood of patients receiving surgery within 1 year. Results for other outcomes were mixed with no differences in several measures. Further research is needed to examine the effectiveness of physical therapy relative to other nonsurgical management strategies for patients with lumbar spinal stenosis.
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Randomized Controlled Trial
Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial.
Analgesic effect of lidocaine infusion on postoperative pain. ⋯ Intraoperative systemic infusion of lidocaine decreases pain perception during microdiscectomy, thus reducing the consumption of opioid and the severity of postoperative pain. This effect contributes to reduce the length of HS.
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Randomized Controlled Trial
Microwave diathermy for treating nonspecific chronic neck pain: a randomized controlled trial.
Although the use of deep heat therapy is widespread, there is scant literature available on its effectiveness in treating back or neck pain. ⋯ Microwave diathermy does not provide additional benefit to a treatment regimen of chronic neck pain that already involves other treatment approaches.