Articles: back-pain.
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This population-based cohort study investigated the association between a lifetime history of a work-related low back injury, in those who had recovered to have no or mild low back pain, and the development of troublesome low back pain (LBP). A secondary analysis explored the possible effects of misclassification of the exposure by examining the association between a lifetime history of having taken time off work or performed light duties at work because of a work-related low back injury. Current evidence from cross-sectional studies suggests that individuals with a history of a work-related low back injury are more likely to experience future LBP. However, there is a need to examine this association prospectively in a large population-based cohort with adequate control of known confounders. ⋯ Our study suggests that a history of work-related low back injury or taking time off work or having to perform light duties at work due to a work-related low back injury may be a risk factor for the development of troublesome LBP. Residual confounding may account for some of the observed associations, but this was less in the group who took time off work or had to work light duties due to a work-related low back injury.
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Pain management in the elderly has increasingly become problematic in the USA as the aged population grows. The proportion of the population over 65 continues to climb and may eclipse 20 % in the next decade. In order to effectively diagnosis and treat these patients, a proper history and physical exam remain essential; pain assessment scales such as the Verbal Descriptor Scales (VDS), the Numerical Rating Scales (NRS), and the Visual Analogue Scales (VAS) often but not always prove beneficial. ⋯ While the normal aging process does not necessarily guarantee symptoms of chronic pain, elderly individuals are far more likely to develop these painful conditions than their younger counterparts. There are many effective treatment modalities available as potential therapeutic interventions for elderly patients, including but not limited to analgesics such as NSAIDs and opioids, as well as multiple interventional pain techniques. This review will discuss chronic pain in the elderly population, including epidemiology, diagnostic tools, the multitude of co-morbidities, and common treatment modalities currently available to physicians.
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A nonrandomized controlled trial. ⋯ 2.
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Conventional spinal cord stimulation (SCS) exhibits pain relief and improved quality of life in refractory failed back surgery syndrome. However, patients suffering from predominant back pain failed to achieve a favorable neuromodulation outcome. Currently, two new stimulation concepts, the burst and the HF10 stimulation paradigms successfully suppress intractable back pain levels in this difficult-to-treat subgroup. To date, literature data comparing both stimulation patterns is lacking. ⋯ Burst and HF10 SCS performed efficiently and safely in intractable FBSS patients with predominant back pain and deserve more refined, specific investigations to determine their efficacy.