Articles: back-pain.
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The lumbar facet joint has long been considered a significant source of low back pain (LBP). Facet blocks with anesthetic and cortisone, and even facet denervation procedures, have been recommended as treatment for patients with LBP. The literature, however, fails to conclusively document the role of the facet in the production of LBP. Based on a review of the literature and the author's clinical studies, the following statements appear to be appropriate and defensible: (1) The lumbar facet joints are very important biomechanically. (2) The facet is not a common or clear source of significant pain. (3) The facet syndrome is not a reliable clinical diagnosis. (4) Injection of intraarticular saline into the facets in control cases is as effective as local anesthetic and steroids in relieving the patient's pain temporarily. (5) Response to facet joint injection in patients with LBP does not correlate with or predict their clinical results after solid posterior lumbar fusion, and it should not be used preoperatively as a clinical criterion in selection of patients for fusion. (6) More prospective, controlled and randomized clinical studies are recommended.
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Lumbar radiculalgia may be due, beside the disc-nerve root conflict, to stenosis of osteoarticular canals, wide dural sac, epidural lipomatosis, segmental arachnoiditis, malignant or benign tumours and meningoradiculitis. Extraspinal truncular or radicular sciatica is usually due to compression by an expansive process. Some types of pain referred from articular structures may mimic sciatica.
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Orthopaedic nursing · Jan 1992
ReviewPerception of control and appraisal of illness in chronic low back pain.
People who experience chronic low back pain face significant changes in their lives, and it is unclear why some people adapt to the pain situation better than others. Using a cognitive appraisal model, outcomes of the pain situation were examined in 40 chronic low back pain patients using situational control and appraisal of illness as predicted mediating factors. This article presents background of the problem and the results of the study.
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Back schools have been proved to be one of the most effective methods of treatment for patients with chronic back pain and disability, and almost every physical therapy clinic now offers some form of education to their back patients. This chapter has attempted to establish what basic information should be available to a person dealing with a back injury, and to offer a logical manner of presenting this information.