Articles: back-pain.
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Int J Obstet Anesth · Oct 2012
Case ReportsEpidural lipomatosis causing new debilitating back pain in a patient with human immunodeficiency virus on highly active antiretroviral therapy.
Spinal epidural lipomatosis is a rare condition of adipose tissue hypertrophy in the epidural space. Through nerve root and spinal canal compression, it may lead to both sensory and motor compromise. Chronic steroid use, obesity and other metabolic derangements are known causes of spinal epidural lipomatosis. ⋯ Epidural lipomatosis was diagnosed by magnetic resonance imaging. Given her evolving symptoms, neuraxial anesthesia was considered to be contraindicated. We present her management and labor course.
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Low back pain is associated with plasticity changes and central hypersensitivity in a subset of patients. We performed a case-control study to explore the discriminative ability of different quantitative sensory tests in distinguishing between 40 cases with chronic low back pain and 300 pain-free controls, and to rank these tests according to the extent of their association with chronic pain. Gender, age, height, weight, body mass index, and psychological measures were recorded as potential confounders. ⋯ As measures of discrimination, we estimated receiver operating characteristics (ROC) and likelihood ratios. Six tests seemed useful (in order of their discriminative ability): (1) pressure pain detection threshold at the site of most severe pain (fitted area under the ROC, 0.87), (2) single electrical stimulation pain detection threshold (0.87), (3) single electrical stimulation reflex threshold (0.83), (4) pressure pain tolerance threshold at the site of most severe pain (0.81), (5) pressure pain detection threshold at suprascapular region (0.80), and (6) temporal summation pain threshold (0.80). Pressure and electrical pain modalities seemed most promising and may be used for diagnosis of pain hypersensitivity and potentially for identifying individuals at risk of developing chronic low back pain over time.
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Complement Ther Med · Oct 2012
Back pain amongst mid-age Australian women: a longitudinal analysis of provider use and self-prescribed treatments.
To analyse use of conventional and complementary and alternative (CAM) practitioners and self-prescribed CAM amongst mid-age Australian women with back pain. ⋯ Back pain is prevalent amongst mid-age Australian women, although only one third sought help. Women who sought help for their back pack were high users of CAM (practitioners and self-prescribed) and conventional care providers, consulting a CAM practitioner in complement with conventional biomedical consultations rather than as an alternative. Further research is needed to explore the complex contemporary landscapes of back pain negotiation and management.
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There are few studies that have looked at the occurrence of co-morbid conditions amongst patients with back problems. This study assesses the association between of a range of co-morbidities and the labour force participation rates of 45- to 64-year-old Australians with back problems. Logistic regression models were applied to the 2003 Survey of Disability, Ageing and Carers (SDAC) data to look at the relationship between chronic back problems, labour force participation and comorbidities. ⋯ For example, an individual with back problems and heart disease is more than 10 times more likely to be out of the labour force than those with back problems alone (OR=10.90, 95% CI=2.91-40.79, P=.0004). Amongst conditions that have a significant impact on labour force participation rates, back problems and multiple co-morbidities are significantly more likely to cause persons with these conditions to be out of the labour force than those with back problems alone or those with no chronic health condition. It is important to consider which co-morbidities an individual has when assessing the impact of back problems on labour force participation, as co-morbid conditions vary in their association with labour force participation.
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J Electromyogr Kinesiol · Oct 2012
ReviewThe basis for spinal manipulation: chiropractic perspective of indications and theory.
It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments. ⋯ This paper reviews the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice. It concludes with discussion of subluxation as an indicator for SM therapy, particularly from the perspective that subluxation may be one contributory cause of ill-health within a "web of causation".