Articles: low-back-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Pain from the lumbar zygapophysial joints: a test of two models.
One hundred seventy-six consecutive patients with chronic low-back pain and no history of previous lumbar surgery were studied to test the clinical criteria of Fairbank et al. and Helbig and Lee for zygapophysial joint pain. All patients underwent a history, examination, and a series of zygapophysial joint injections or blocks of the medial branches of the dorsal ramus with lignocaine. ⋯ None of the clinical features tested was found to be associated with response to the confirmatory block. The Fairbank et al. and Helbig and Lee criteria were shown to be unreliable in distinguishing pain of zygapophysial joint origin from pain of other origins.
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Int J Clin Pharm Th · Apr 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialParenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study.
Two hundred and sixty patients with lumbago or sciatic pain participated in a multicenter observer-blind randomized trial to compare the efficacy and tolerability of dipyrone 2.5 g, diclofenac 75 mg, and placebo administered as an intramuscular injection once daily for the duration of one to two days. The effectiveness of the test treatments in relieving sciatic pain was measured by a visual analog scale (VAS) before and 30 minutes, 1, 2, 3, 6 and 24 hours after each injection. In addition, the patient's general well-being was measured on a 5-point rating scale on day 0, 1 and 2. ⋯ Pain intensity on VAS (primary endpoint) showed a significantly greater reduction with dipyrone than with diclofenac or placebo between 1 and 6 hours after application (p < 0.01) and at the end of the trial (after 48 hours). Improvement in general well-being and minimal finger-toe distance was greatest in the dipyrone group. 59% of the patients with dipyrone assessed the overall efficacy as "excellent" or "very good", compared with 30% with diclofenac, and 18% with placebo. Adverse reactions were reported in only 7 patients (3%), 4 (5%) in the dipyrone, 1 (1%) in the diclofenac, and 2 (2%) in the placebo group.
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Multicenter Study
Intertester reliability of McKenzie's classifications of the syndrome types present in patients with low back pain.
The McKenzie system for examining and treating patients with low back pain is frequently used by clinicians. The primary purpose of this multicenter study was to determine the intertester reliability of assessments of patients with low back pain when physical therapists used the McKenzie method. A second purpose was to determine if previous postgraduate training in the McKenzie system affects reliability. ⋯ Therapists agreed on which syndrome was present 39% of the time. Previous postgraduate training did not improve reliability. The results suggest that assessments of the syndrome present in patients with low back pain appear to be unreliable when using the McKenzie system.
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Scand J Prim Health Care · Jun 1993
Randomized Controlled Trial Multicenter Study Clinical TrialManual therapy with steroid injections in low-back pain. Improvement of quality of life in a controlled trial with four months' follow-up.
To compare prospectively the effect of manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections with standardized conventional but optimized activating treatment by primary health care teams. ⋯ Manual treatment with steroid injections was superior to conventional treatment in minimizing mental and somatic symptoms and increasing quality of life, in parallel with other measures of improvement.
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Scand J Prim Health Care · Sep 1992
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA controlled, multicentre trial of manual therapy in low-back pain. Initial status, sick-leave and pain score during follow-up.
101 outpatients with acute or subacute low-back pain were randomly allocated to one of two treatment groups. One group was given standardized conventional but optimal activating treatment by primary health care teams. The other group received manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections. ⋯ The difference diminished over time but was still significant after eight months. Two slightly different pain scores ("pain at the moment" and "pain during the last weeks"), initially similar in the two groups, diminished in both groups but were significantly lower in the manual treatment group during the study. The group receiving specific manual treatment thus had a significantly better outcome than the group receiving conventional treatment as far as sick-leave and pain score are concerned.