Articles: low-back-pain.
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A cross-sectional study targeted a total of 43,630 pupils in Niigata City, Japan was performed. The objective was to clarify the present incidence of low back pain (LBP) in childhood and adolescence in Japan. It has recently been recognized that LBP in childhood and adolescence is also as common a problem as that for adults and most of these studies have been conducted in Europe, however, none have so far been made in Japan. ⋯ The severity of LBP included 81.9% at level 1, 13.9% at level 2 and 4.2% at level 3. It was revealed that LBP in childhood and adolescence is also a common complaint in Japan, and these findings are similar to previous studies conducted in Europe. LBP increased as the grade level increased and it appeared that the point and lifetime prevalence in adolescence are close to the same levels as those seen in the adulthood and there was a tendency to have more severe LBP in both cases who experienced pain for more than 1 month and those with recurrent LBP.
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Lumbosacral transforaminal epidural steroid injections (LS-TFESIs) are an accepted procedure used in the comprehensive, conservative care for lumbar disc pathology and/or spinal stenosis induced low back pain with a radicular component. Historically, the terminology used to describe the transforaminal technique of instilling medications into the epidural space and/or exiting structures has varied. These procedures have also been referred to as either diagnostic or therapeutic selective nerve root blocks (SNRBs). Although this procedure is typically used to "selectively" treat isolated pathology, the "SNRB" terminology suggests that one can selectively diagnose or treat a specific nerve root as a pain generator by anesthetizing or blocking it. It has been recently demonstrated that L4 and L5 SNRBs are often non-"selective" by investigating the extent of epidural contrast flow patterns after injecting 1.0 mL of contrast. Our study attempts to identify the minimum injectate volume at which LS-TFESIs may still be considered "selective" with no injectate extending to either the adjacent (superior and/or inferior) levels or to the contralateral side. ⋯ Diagnostic LS-TFESI or SNRB blocks limiting injectate to a single, ipsilateral segmental level cannot reliably be considered diagnostically selective with volumes exceeding 0.5mL. Injectate volumes greater than 0.5mL are consistently non-selective and cannot be used reliably for diagnostic block procedures in the epidural space.
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Ann Readapt Med Phys · Nov 2008
Management of low back pain in primary care prior to multidisciplinary functional restoration: a retrospective study of 72 patients.
Chronic low back pain is a major socioeconomic health issue, due to the high direct (healthcare) and indirect (sick leave) costs. The aim of the present study was to describe the primary care management of low back pain patients prior to their inclusion in a multidisciplinary functional restoration network. ⋯ The time interval before referral to a multidisciplinary care team is long and so GPs should be encouraged and helped to organize this process earlier. It is also essential to determine factors which predict progression to chronic LBP.
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Arch Phys Med Rehabil · Nov 2008
Comparative StudySources of sacroiliac region pain: insights gained from a study comparing standard intra-articular injection with a technique combining intra- and peri-articular injection.
To present evidence supporting the existence of extra-articular sources for sacroiliac region pain and to present evidence that intra-articular anesthetic blockade may underestimate the true prevalence of sacroiliac region pain. ⋯ Significant extra-articular sources of sacroiliac region pain exist. Intra-articular diagnostic blocks underestimate the prevalence of sacroiliac region pain.
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Smoking may be a major problem in chronic low back pain (LBP) patients. The goal of this study was to determine whether smoking status affected multidisciplinary pain facility treatment outcome. ⋯ Current smoking status appears to be associated with poorer treatment outcome after multidisciplinary pain facility treatment. Return to work within smokers is predicted by pain and worker compensation status. Pain facilities should target current smokers with significant perceived pain for close treatment monitoring in an attempt to improve treatment outcome.