Articles: back-pain.
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Psychodynamic concepts postulate a psychogenesis of physical pain proposing several assumptions about the conversion of mental suffering into physical pain. Behavioural concepts, on the other hand, emphasize psychological conditions as risk factors for chronicity and describe psychological reactions to chronic pain. Patients with painful diseases and inadequate coping strategies very often display symptoms of anger, anxiety, or depression. ⋯ Subjects included in the study were given diagnoses of low back pain, tension headache, rheumatoid arthritis, and ankylosing spondylitis. Treatment effects in different diagnostic groups were compared to each other, supporting the assumption that pain reduction is greatest in low back pain and least in ankylosing spondylitis. Subjects with inflammatory rheumatic diseases showed some improvement in self-reported physical complaints and in their feelings of well-being.
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A laboratory study was conducted in an effort to reduce back stress for nursing personnel while performing the patient handling tasks of transferring the patient from bed to wheelchair and wheelchair to bed. These patient handling tasks were studied using five manual techniques and three hoist-assisted techniques. The manual techniques involved one-person and two-person transfers. ⋯ Pulling techniques and hoists took significantly longer amounts of time to make the transfer than manually lifting the patient (P less than or equal to 0.01). The two-person walking belt using a pulling technique and Ambulift are recommended for transferring patients from bed to wheelchair and wheelchair to bed. A large-scale field study is needed to verify these recommendations.
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J Manipulative Physiol Ther · Mar 1991
The relationship between the medial branch of the lumbar posterior ramus and the mamillo-accessory ligament.
Gross dissection anatomical studies have investigated the course of the human lumbar posterior primary ramus and its branches. This nerve has frequently been associated with low back pain; however, the cross-sectional area of the space beneath the mamillo-accessory ligament, which is occupied by the medial branch of the posterior primary ramus, has not been clearly defined. ⋯ The main findings are that the medial branch of the posterior primary ramus occupies only a small percentage (approximately 3%) of the space enclosed by the mamillo-accessory ligament, and that it is surrounded by adipose tissue which provides an adequate protective "cushion" around it. Therefore, it is unlikely that the medial branch of the posterior primary ramus could be trapped beneath the mamillo-accessory ligament and cause pain.
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Two cases of low back pain from quadratus lumborum myofascial trigger points are presented. One of the patients suffered from an acute episode while the other had a chronic condition. This condition may be more common than previously believed. ⋯ Thoracolumbar joint dysfunction may often coexist with quadratus lumborum myofascitis and must be treated for optimal results. Myofascial therapy directed at restoring muscle length and function, coupled with joint manipulation to related dysfunctional areas, was implemented. Diagnosis and treatment are outlined.
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Psychophysiological recordings (electrodermal activity, heart rate, respiration rate and frontalis and back muscle tension) were taken in chronic low back pain (CLBP) patients and control subjects during baseline conditions and during the presentation of six acute pressure pain stimuli. No baseline differences in back muscle tension between CLBP patients and controls were found, but CLBP patients did have higher baseline electrodermal activity. During pain stimulation, CLBP patients showed larger skin conductance reactions than controls. ⋯ Contrary to expectation, no differences were found between CLBP patients and controls in physiological habituation after repeating the pain stimulus. Comparison of subjective pain ratings and psychophysiological variables showed that for control subjects arousal and subjective pain were related. For CLBP patients there was no such clear relationship.