Articles: back-pain.
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Background Pain after a SARS-CoV-2 acute infection (post-COVID pain) is becoming a new healthcare emergency but remains underestimated and most likely undertreated due to a lack of recognition of the phenomenon and knowledge of the underlying pain mechanisms. Evidence supporting any particular treatment approach for the management of post-COVID pain is lacking. Large variability in the patient response to any standard pain treatments is clinically observed, which has led to calls for a personalized, tailored approach to treating patients with chronic post-COVID pain (i.e. 'precision pain medicine'). ⋯ Further, the consideration of other factors, such as gender, comorbidities, treatments received at the acute phase of infection for onset-associated COVID-19 symptoms, factors during hospitalization or the presence of emotional disturbances should be implemented into a treatment programme. Conclusions Accordingly, considering these factors, management of post-COVID pain should include multimodal pharmacological and non-pharmacological modalities targeting emotional/cognitive aspects (i.e. psychological and/or coping strategies), central sensitization-associated mechanisms (i.e. pain neuroscience education), exercise programmes as well as lifestyle interventions (e.g. nutritional support and sleep management). SIGNIFICANCE: This position paper presents an evidence-based clinical reasoning approach for precision management of post-COVID pain.
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The present study is an attempt to validate the Hindi version of the EuroQoL (EQ-5D-3L) questionnaire for patients with chronic low back pain (CLBP). ⋯ The Hindi version of the EQ-5D-3L demonstrated comprehensibility, reliability and proved to be a valid instrument for the evaluation of health-related quality of life in CLBP patients.
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Lumbar spondylolysis is one of the most common causes of low back pain and primarily affects children and adolescents. Traditional posterior lumbar fixation and interbody fusion surgery has always been the most effective method to treat spondylolysis. However, traditional surgical management has limitations of large trauma, complex operation, high cost, postoperative biomechanical deterioration, and resulting complications. ⋯ A novel minimally invasive therapeutic approach is presented herein of an SEC injection guided by C-arm fluoroscopy to treat lumbar spondylolysis. We describe a novel technique applied in a patient with lumbar spondylolysis, who showed significantly improved low back pain symptoms and a computed tomography scan, including osseous fusion of the bilateral isthmus at L4 after SEC therapy. This is the first reported case description of using an SEC injection to treat lumbar spondylolysis with a successful clinical outcome.
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Meta Analysis
Incidence of lumbar spondylolysis in athletes with low back pain: A systematic evaluation and single-arm meta-analysis.
Low back pain (LBP) is a common chief complaint from athletes. Lumbar spondylolysis (LS) is a common sport injury. Severe LS is likely to cause spinal instability, resulting in lumbar spondylolisthesis or lumbar disc herniation, and even damage to the spinal nerve roots. The incidence of LS is approximately 5% in the adult population, and nearly half of young athletes with LBP are diagnosed with LS. This meta-analysis analyzed the incidence of LS in athletes with LBP. ⋯ The estimated prevalence of LS in athletes with LBP is 41.7%, and future correlations between the prevalence of LS in adolescent athletes worldwide need to be assessed from different perspectives, including biomechanical, hormonal, anatomical, behavioral, and gender differences.
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Randomized Controlled Trial
Hypertonic glucose in the treatment of low back pain: A randomized clinical trial.
Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is not known, but osmotic agents (hypertonic solutions of dextrose or glucose) cause cellular rupture and an inflammatory response that releases cytokines and growth factors that lead to scarring and reinnervation. ⋯ Both groups significantly improved on the evaluated scales during follow-up. Overall, no effects were attributable to the glucose components or the prolotherapy protocol.