Articles: back-pain.
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Opioids are used not only in the treatment of cancer pain, but also pain of non-malignant genesis. In recent years, the efficacy of controlled release (CR) oxycodone in the treatment of the above-mentioned types of pain has been investigated in a number of clinical studies. The present article reviews the clinical studies that have been already published. ⋯ Since there are no clinical relevant metabolites, there is no danger of accumulation in patients with renal infarction due to these metabolites. Side effects are those typical for opioids, and are readily manageable. CR oxycodone is a good alternative in the treatment of non-cancer pain and can be recommended as first-line treatment for the above-mentioned indications.
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Review Meta Analysis
Physical conditioning programs for workers with back and neck pain: a cochrane systematic review.
To determine the effect on time lost from work of physical conditioning programs for workers with back and neck pain. DATA SOURCES Randomized trials were located by searching MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Controlled Trial Register, and PEDro. ⋯ Physical conditioning programs that incorporate a cognitive-behavioral approach reduce the number of sick days for workers with chronic back pain when compared to usual care.
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Review Meta Analysis
Radiofrequency denervation for neck and back pain: a systematic review within the framework of the cochrane collaboration back review group.
Systematic review. ⋯ There is limited evidence that radiofrequency denervation offers short-term relief for chronic neck pain of zygapophysial joint origin and for chronic cervicobrachial pain, and conflicting evidence for its effectiveness for lumbar zygapophysial joint pain. There is limited evidence suggesting that intradiscal radiofrequency may not be effective in relieving discogenic low back pain. Further high-quality randomized controlled trials are needed, with larger patient samples and data on long-term effects, for which current evidence is inconclusive.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisRadiofrequency denervation for neck and back pain. A systematic review of randomized controlled trials.
The diagnosis of cervical or lumbar zygapophyseal joint pain can only be made by using local anesthesia to block the nerves supplying the painful joint. There is a lack of effective treatment for chronic zygapophyseal joint pain or discogenic pain. Radiofrequency denervation appears to be an emerging technology, with substantial variation in its use between countries. ⋯ The selected trials provide limited evidence that radiofrequency denervation offers short-term relief for chronic neck pain of zygapophyseal joint origin and for chronic cervicobrachial pain; conflicting evidence on the short-term effect of radiofrequency lesioning on pain and disability in chronic low-back pain of zygapophyseal joint origin; and limited evidence that intradiscal radiofrequency thermocoagulation is not effective for chronic discogenic low-back pain. There is a need for further high-quality RCTs with larger patient samples and data on long-term effects, for which current evidence is inconclusive. Furthermore, RCTs are needed in non-spinal indications where radiofrequency denervation is currently used without any scientific evidence.
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Cochrane Db Syst Rev · Jan 2003
Review Meta AnalysisWork conditioning, work hardening and functional restoration for workers with back and neck pain.
Physical conditioning programs, variously called work conditioning, work hardening and functional restoration/exercise programs, aim to improve work status and function. Previous attempts have been made to evaluate the efficacy of work-oriented back pain management programs, but none have focused exclusively on work or functional outcomes. ⋯ Physical conditioning programs that include a cognitive-behavioural approach plus intensive physical training (specific to the job or not) that includes aerobic capacity, muscle strength and endurance, and coordination; are in some way work-related; and are given and supervised by a physiotherapist or a multidisciplinary team, seem to be effective in reducing the number of sick days for some workers with chronic back pain, when compared to usual care. However, there is no evidence of their efficacy for acute back pain.