Articles: back-pain.
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Assessment and treatment responses were compared in 17 subjects with chronic low back pain assessed as showing at least one clear consciously produced inconsistency in statements and/or behaviors during their participation in an interdisciplinary treatment program and 143 subjects assessed as showing no such inconsistency. Numerous statistically significant differences emerged: Inconsistent subjects were more likely to have pending litigation and to be assessed by staff as showing a higher degree of focus on pain and more dramatized complaints, lower levels of medical findings and attention and interest in treatment, and poor compliance with treatment and assessment procedures. ⋯ Though not definitive, these results suggested a syndrome of characteristics among such subjects which are similar to those proposed as likely characterizing malingerers. The need for a particularly careful validation of self-report data in patients showing many of these characteristics was emphasized.
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The McKenzie approach to evaluating and treating low back and neck pain is an exciting development in clinical medicine. A thorough mechanical assessment as described by McKenzie is informative and appropriate for all such patients and identifies an individualized self-treatment program that is often dramatically successful. ⋯ The assessment process and McKenzie's classification of low back pain syndromes--postural, dysfunctional, and derangement--are described. Therapeutic regimens emphasizing patient self-treatment for the current episode are presented, with the long-range goal of preventing recurrences.
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To examine the relation between epidural anaesthesia and long term backache after childbirth. ⋯ The relation between backache and epidural anaesthesia is probably causal. It seems to result from a combination of effective analgesia and stressed posture during labour. Further investigations on the mechanisms causing backache after epidural anaesthesia are required.