Articles: back-pain.
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Randomized Controlled Trial Clinical Trial
The secondary prevention of low back pain: a controlled study with follow-up.
The current investigation studied the effectiveness of a secondary prevention program for nurses with back pain who were deemed at risk for developing a chronic problem. A 2 X 3 repeated measures design was employed with 2 groups and 3 assessment periods. The treatment group received an intervention designed to reduce current problems, but above all to prevent reinjury and minor pains from becoming chronic medical problems, and it included a physical and behavioral therapy package. ⋯ These differences were generally maintained at the 6 month follow-up. In addition, the treatment group broke a trend for increasing amounts of pain-related absenteeism, while the control group did not. Taken as a whole, the results suggest that a secondary prevention program aimed at altering life style factors may represent an effective method for dealing with musculoskeletal pain problems.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1989
Review Randomized Controlled Trial Clinical Trial[Lumbar facet joint syndrome. Significance of non-organic signs. A randomized placebo-controlled clinical study].
One hundred and nine patients with chronic (greater than 3 months) unilateral low back pain had less than or equal to 2/5 or greater than or equal to 3/5 inappropriate signs (IAS) in 65 and 44 cases, respectively. The patients were randomized in three therapy groups: cortison and local anaesthetic injected intra-articularly into two facet joints (28 patients), the same mixture injected pericapsularly around two facet joints as well (39 patients) and injection of physiologic sodium hydrochloride intra-articularly into two facet joints (42 patients). The effect of the treatment was evaluated within an hour, two and six weeks after the treatment with work status, pain scale, disability score and movements of the lumbar spine. ⋯ Identification of these patients may also prevent the doctor from a burn-out syndrome after many failed treatments. This study also shows that if a biological effect of a treatment is to be studied the patients with multiple IAS should be excluded from the material. There was no difference in the results when either intra-articular or pericapsular cortisone and local anaesthetic or saline intra-articularly was used.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Changes in innominate tilt after manipulation of the sacroiliac joint in patients with low back pain. An experimental study.
The purposes of this study were to 1) propose a method to detect sacroiliac joint dysfunction (SIJD), 2) test the interrater reliability of the method on a group of patients with low back pain (LBP), and 3) document changes in innominate tilt after manipulation of the sacroiliac joint. Criteria for SIJD were established by the authors. Twenty-six patients with unilateral LBP were examined independently for presence of SIJD by two examiners. ⋯ Data were analyzed using a mixed three-factor analysis of variance. The data analysis revealed that the manipulation procedure resulted not only in an altered innominate tilt of the same side but also in an equal and opposite tilt of the opposite side (F = 67.07; df = 1.18; p less than .05). The results indicate that SIJD can be identified reliably in patients with LBP and that a manipulative procedure purported to be specific to the sacroiliac joint changes innominate tilt bilaterally and in opposite directions.
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J Consult Clin Psychol · Apr 1988
Randomized Controlled Trial Comparative Study Clinical TrialComparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine.
Acute soft tissue injuries create pain and limitation of function. Treatment requires analgesia and time for full recovery. Acetaminophen with codeine (650 mg plus 60 mg, respectively, every 4 to 6 hours) is used frequently as the analgesic of choice. ⋯ However, 65 percent of acetaminophen with codeine patients experienced side effects, with 35 percent of these patients stopping the medication because of intolerable side effects. In the diflunisal group, 28 percent of the patients experienced side effects and 5 percent had to stop the medication early. Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine.