Articles: low-back-pain.
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Review Meta Analysis
Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis.
Background and Objectives: Because most individuals with chronic back pain (CLBP) have no specific cause, it is usually described as central sensitization. Pain neuroscience education (PNE) in top-down pain control may be effective against carryover effects; however, this remains unclear. In this study, the carryover effect was qualitatively and quantitatively synthesized and analyzed. ⋯ Results: Nine RCTs involving 1038 individuals with CLBP were included in the analysis. Four main results were identified: First, PNE had a short-term carryover effect on pain intensity (SMD = -1.55, 95% confidence interval [CI] = -2.59 to -0.50); second, PNE had a short-term carryover effect on pain catastrophizing (SMD = -2.47, 95% CI = -3.44 to -1.50); third, PNE had short- and long-term carryover effects on kinesiophobia (SMD = -3.51, 95% CI = -4.83 to -2.19); fourth, the appropriate therapeutic intensity of PNE for the pain intensity of individuals (SMD = -0.83, 95% CI = -1.60 to -0.07). Conclusions: PNE has a short-term carryover effect on pain intensity and pain cognition in individuals with CLBP and a long-term carryover effect on kinesiophobia.
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Observational Study
Cross-cultural adaptation and validation of simplified Chinese version of the Waddell Disability Index for patients with nonspecific low back pain in Mainland China.
The current study aimed to translate the Waddell Disability Index (WDI) in a cross-cultural fashion, and evaluate the reliability and validity of the adapted simplified Chinese version (SC-WDI) for patients with nonspecific low back pain (LBP). The cross-cultural adaptation of the SC-WDI was conducted following international guidelines. The reliability and validity of the SC-WDI was assessed in a prospective observational study. ⋯ The SC-WDI demonstrated a good acceptability, score distribution, internal consistency, test-retest reliability and validity. It has high sensitivity in evaluating the HRQOL. Therefore, it is was considered as a satisfactory tool for evaluating HRQOL of Chinese patients with LBP.
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Randomized Controlled Trial
Efficacy of Continuous Intrathecal Infusion Trialing with a Mixture of Fentanyl and Bupivacaine in Chronic Low Back Pain Patients.
Intrathecal trialing is used as a screening prognostic measure prior to intrathecal drug delivery system implant. The purpose of this study was to determine the efficacy of a continuous intrathecal infusion of an admixture of bupivacaine and fentanyl in patients with chronic low back pain. Patients with refractory chronic low back pain in the setting of previous lumbar spine surgery and/or chronic vertebral compression fracture(s) were enrolled in a randomized double blind cross-over study comparing saline infusion to infusion of a solution containing bupivacaine combined with low-dose fentanyl over a 14-18 hour period. ⋯ At 12 months following implant, primary and secondary outcome measures continued to be significantly reduced from baseline. Continuous intrathecal delivery of a combination of zlow-dose fentanyl with bupivacaine is superior to saline in screening intrathecal trialing for back pain reduction. With longer term delivery, a sustained reduction of chronic low back pain was also observed.
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Review Meta Analysis
Novel Spinal Cord Stimulation Waveforms for Treating Back and Leg Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Spinal cord stimulation (SCS) has been suggested as a treatment option to improve the quality-adjusted life years of individuals with low back pain. However, previous reviews have some methodologic limitations. This review aims to evaluate the effectiveness of novel SCS waveforms on pain outcomes in patients with low back pain (LBP) compared with traditional SCS or placebo comparator. ⋯ With low certainty of evidence, this finding provides a rationale for considering the novel SCS waveform as complements to the usual therapeutic plan. Future trials should adopt well-designed RCTs with larger sample size and follow-up assessment.
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Anesthesia and analgesia · Jul 2023
Meta AnalysisAnalgesic Effect of Buprenorphine for Chronic Noncancer Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Transdermal & buccal buprenorphine is associated with a small reduction in pain scores in chronic non-cancer pain.
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