Articles: back-pain.
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Scand J Rehabil Med · Jan 1989
The Swedish back school in chronic low back pain. Part II. Factors predicting the outcome.
The aim of the study was to analyse the factors predicting the outcome of the Swedish back school and spontaneous recovery in chronic low back pain. The predicting variables describing the treatment group (n = 95) and the control group (n = 93) at the initiation of study included sociodemographic factors, variables related to work, severity of low back pain, and a number of clinical measurements and evaluations. The Oswestry Low Back Pain Disability Questionnaire was used for judging recovery factors. It was found that the best predictor for the outcome of the treatment and for spontaneous recovery was work satisfaction.
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Disc deterioration and pain provocation in different low-back pain syndromes was studied using computed tomography (CT) discography. Data were prospectively collected for 300 patients (816 discs). ⋯ Eighty-two percent of DH patients, 80% of DD, 56% of LS, and 59% of LRS patients had both positive discographic pain provocation and moderate or severe disc deterioration. The study indicates that intradiscal pathology plays a major role in nonspecific low-back pain syndromes.
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Journal of neurosurgery · Oct 1988
Case Reports Comparative StudyQuantification of thermal asymmetry. Part 2: Application in low-back pain and sciatica.
Temperature differences between the lower extremities were measured using a computerized thermometric scanning system in order to compare the degree of thermal asymmetry in 144 patients with low-back pain. The patients displayed highly significant thermal asymmetries, with the involved limb being cooler (p less than 0.001). ⋯ In this group of patients, thermometric study provides physicians with important information for proper decision making. The test can be performed to avoid more invasive and probably less revealing diagnostic or exploratory surgical procedures.
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Comparative Study
Managing low back pain--a comparison of the beliefs and behaviors of family physicians and chiropractors.
Random samples of 605 family physicians and 299 chiropractors in Washington were surveyed to determine their beliefs about back pain and how they would respond to three hypothetic patients with back pain. With 79% of the family physicians and 70% of the chiropractors responding, family physicians and chiropractors differed greatly not only in their technical approaches to back pain--such as drug therapy versus spinal manipulation--but also in their underlying beliefs and attitudes. ⋯ Family physicians were more likely than chiropractors to feel frustrated by patients with back pain, less likely to think they can help patients prevent future episodes of back pain, and less confident that their patients are satisfied with their care. Studies are needed to determine whether the different perspectives of family physicians and chiropractors are associated with differences in the costs and outcomes of care.
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The present study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) in understanding the relationship between duration of chronic pain and psychiatric difficulties. The MMPI responses of workers' compensation patients with varying levels of low back pain chronicity were compared. One hundred ninety eight patients, divided into three groups according to length of disability, underwent social history interviews and completed the MMPI. ⋯ A series of analysis of variance designs revealed that those who were disabled for two or more years evidenced significantly more depression and psychopathology than those who were disabled for less than one year. Further statistical evaluation of 200 social history variables did not reveal significant differences between the three groups on most variables. In conjunction with previous research, the results suggested a causative link between disability and psychiatric disease.