Articles: low-back-pain.
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The benefit of intradiscal glucocorticoid injection (IGI) for discogenic low back pain (LBP) remains controversial. ⋯ Low back pain, lumbar back pain, intradiscal glucocorticoid injection, modic changes, meta-analysis.
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The purpose of this study was to systematically review the evidence on inflammatory biomarkers as analytic predictors of non-specific low back pain (NsLBP). Low back pain (LBP) is the number one cause of disability globally, posing a major health problem that causes an enormous social and economic burden, and there is an increasing interest on the importance of biomarkers in quantifying and even emerge as potential therapeutic tools to LBP. ⋯ This systematic review found evidence of increased levels of pro-inflammatory biomarkers CRP, IL-6 and TNF-α and decreased levels of anti-inflammatory biomarker IL-10 in patients with LBP. Hs-CRP was not correlated with LBP. There is insufficient evidence to associate these findings with the degree of pain severity or the activity status of the lumbar pain over time.
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This prospective longitudinal study compares outcomes between Medicare beneficiaries receiving percutaneous image-guided lumbar decompression (PILD) using the mild® procedure and a control group of patients receiving interspinous spacers for the treatment of lumbar spinal stenosis (LSS) with neurogenic claudication (NC). ⋯ This comprehensive study of real-world Medicare claims data demonstrated a significantly lower rate of harms for the mild procedure compared to interspinous spacers for patients diagnosed with LSS with NC, and a similar rate of subsequent interventions during 2-year follow-up.
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Preventive medicine · Sep 2023
Musculoskeletal pain intensity and risk of long-term sickness absence in the general working population: A prospective cohort study with register follow-up.
Determining predictors of sickness absence could allow for better screening, guidance, and development of preventive efforts aimed at those in increased risk. This study aimed to determine the prospective association between musculoskeletal pain intensity and risk of incident register-based long-term sickness absence in the general working population, as well as to determine the population attributable fraction. Drawing on data from a nation-wide questionnaire survey, this prospective cohort study followed a representative sample of the Danish general working population without recent long-term sickness absence (≥6 consecutive weeks) (n = 69,273) for long-term sickness absence up to two years (mean follow-up: 93 weeks) in a national register. ⋯ We observed a clear dose-response association between musculoskeletal pain intensity of the neck/shoulder or low-back and the risk of incident long-term sickness absence, with a lower threshold of increased risk of 4 and 3 (scale 0-10) for neck/shoulder (HR (95% CI): 1.25 (1.09-1.42)) and low-back pain (HR (95% CI): 1.13 (1.00-1.29)), respectively. Prevention of pain intensities at or above 4 out of 10 could potentially prevent 17% (population attributable fraction, PAF (95% CI): 16.8 (13.6-20.1)) of the total long-term sickness absence in the general working population. Large-scale interventions to prevent and manage musculoskeletal pain need to be documented and implemented.
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Fear avoidance beliefs questionnaire (FABQ), Tampa scale of kinesiophobia (TSK), and pain catastrophizing scale (PCS) are tools widely used to measure fear-avoidance beliefs, fear of movement, and pain-related catastrophic thinking in people with chronic spinal disorders. ⋯ The results of this study demonstrated that the Persian version of FABQ, TSK, and PCS have sufficient responsiveness and good ability to measure meaningful clinical changes in people with patient CNNP. The MIC scores of the FABQ, TSK, and PCS can help clinicians and researchers to detect changes significant to the patient following a rehabilitation program.