Articles: back-pain.
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Most patients with chronic low back pain associate strenuous physical activities with increased pain. This association can cause avoidance of those activities believed to cause intolerable discomfort. This study explored the relationship of performance of physical activities with self-reported pain measures in 40 consecutive patients with disabling low back pain (mean duration 17 months) during a functional restoration rehabilitation program (mean treatment period 7 weeks). ⋯ At completion of treatment, significant improvement in performance on all physical tests was found, but these were not associated with consistent changes in pain measures. These results demonstrate that subjects with chronic low back pain can increase their physical performance abilities within their same pain experiences. Medical recommendations for subjects' involvement in physical activities should not be based solely on the reported association of pain with those activities.
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Comparative Study
[Prevalence and persistence of back pain in foreign workers: class or culture-induced?].
Physically working people are more likely to suffer from backache. Not only is their work hard and menial but usually also degrading. Unpleasant circumstances such as an offensive environment, the monotony of work, poor qualifications or unsatisfactory work generally influence the persistence of pain. ⋯ The accumulation of negative factors is closely connected to his role of a foreign worker, whereas cultural aspects do not seem to be determining. Therefore, the foreign patient's rehabilitation can be fostered and improved by adopting the same methods used with Swiss patients against the chronicisation of backache. Nevertheless, the mentioned unfavourable factors and additional language problems considerably foil all efforts to a successful rehabilitation.
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Large administrative databases are increasingly valuable tools for health care research. Although increased access to these databases provides valuable opportunities to study health care utilization, costs and outcomes and valid and comparable results require explicit and consistent analytic methods. Algorithms for identifying surgical and nonsurgical hospitalizations for "mechanical" low back problems in automated databases are described. ⋯ Twenty-seven diagnosis and two procedure codes identify hospitalizations for problems definitely in the lumbar or lumbosacral region. Exclusion criteria were developed to eliminate nonmechanical causes of low back pain, such as malignancies, infections, and major trauma. The use of the algorithms is illustrated using national hospital discharge data.