Articles: low-back-pain.
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Systematic review. ⋯ Surgery for radiculopathy with herniated lumbar disc and symptomatic spinal stenosis is associated with short-term benefits compared to nonsurgical therapy, though benefits diminish with long-term follow-up in some trials. For nonradicular back pain with common degenerative changes, fusion is no more effective than intensive rehabilitation, but associated with small to moderate benefits compared to standard nonsurgical therapy.
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Randomized Controlled Trial Comparative Study
Impact of chronic musculoskeletal pathology on older adults: a study of differences between knee OA and low back pain.
The study aimed to compare the psychological and physical characteristics of older adults with knee osteoarthritis (OA) vs those of adults with chronic low back pain (CLBP) and to identify psychological and physical predictors of function as measured by gait speed. ⋯ Older adults with chronic pain may have distinct psychological and physical profiles that differentially impact gait speed. These findings suggest that not all pain conditions are the same in their psychological and physical characteristics and may need to be taken into consideration when developing treatment plans.
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Randomized Controlled Trial Comparative Study
Effectiveness of physical therapy and epidural steroid injections in lumbar spinal stenosis.
Randomized single-blind controlled trial. ⋯ Epidural steroid injections and physical therapy both seem to be effective in LSS patients up to 6 months of follow-up.
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Psychoneuroendocrinology · May 2009
Comparative StudySalivary cortisol and psychological mechanisms in patients with acute versus chronic low back pain.
This study was designed to explore whether the basal adrenocortical activity is related with pain-related coping, nonverbal pain behavior, depressive mood, and fatigue in patients with acute and chronic nonspecific low back pain. 19 patients with acute low back pain (ALBP) and 24 with chronic low back pain (CLBP) participated in the study. The adrenocortical activity was assessed through the cortisol awakening response. All participants provided five saliva samples (0, 15, 30, 45, and 60min after waking) on two consecutive days off work. ⋯ Among CLBP patients, FAC, NPB, depressive mood, and fatigue were negatively associated with the cortisol awakening response, whereas EC tended to be positively associated with it. The results indicate that pain-related coping strategies which are expected to be successful appear to lower the adrenocortical activity among ALBP patients, whereas affective distress may enhance the level of cortisol in this group. Among CLBP patients, long-term maladaptive coping strategies might contribute to hypocortisolism.
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Arch Orthop Trauma Surg · May 2009
Evaluation of responsiveness of Oswestry low back pain disability index.
To assess the response of Oswestry disability index (ODI) among patients undergoing caudal epidural steroid injections for lumbosacral radicular pain. ⋯ This study shows that ODI can detect small changes in disability over time in patients undergoing caudal epidural injections for lumbosacral radicular pain. It can also differentiate between small and large changes in the level of disability.