Articles: back-pain.
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Lumbar facet arthropathy is a common cause of low back pain. Literature supports treatment with radiofrequency ablation (RFA) of associated nerves that innervate lumbar facets when alternative conservative therapies have failed. Diagnostic local anesthetic blocks precede therapeutic ablation, but have a false-positive rate of 27%-63%, and some authors have questioned their utility in predicting therapeutic response to RFA. The authors of the current study believe that injectate volume may be a contributing factor to false positivity. ⋯ NA.
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Randomized Controlled Trial Comparative Study
Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial.
To assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body. ⋯ Percutaneous vertebroplasty did not result in statistically significantly greater pain relief than a sham procedure during 12 months' follow-up among patients with acute osteoporotic vertebral compression fractures.
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Review Meta Analysis
Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis.
Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for 4 chronic pain conditions. We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. ⋯ We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. Although factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain after acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominantly by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment.
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Limited evidence exists on secular trends of analgesics for spinal pain. We investigated general practitioner's (GP) recommendations of analgesic medicines for spinal pain and investigated characteristics associated with their recommendation. ⋯ GP's analgesic recommendations for spinal pain have become increasingly divergent from guideline recommendations over time.