Articles: low-back-pain.
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Mechanical low back pain secondary to degenerative facet joint changes is a common reason for referral to pain clinics. When these changes cause encroachment into the intervertebral foramen, radicular pain may result. While pulsed radiofrequency of the dorsal root ganglion can be used in this setting, the anatomic deformity may make the transforaminal approach difficult. We report a case where a trans-facet approach was used successfully and describe the technique.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Treatment expectancy and credibility are associated with the outcome of both physical and cognitive-behavioral treatment in chronic low back pain.
Patients' initial beliefs about the success of a given pain treatment are shown to affect final treatment outcome. The Credibility/Expectancy Questionnaire (CEQ) has recently been developed as measure of treatment credibility and expectancy. ⋯ Although the associations found were low to modest, these results underscore the importance of expectancy and credibility for the outcome of different active interventions for CLBP and might contribute to the development of more effective treatments.
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The aim of the study was to identify patient factors that correlate with a strong response to opioid pain medications in low back pain patients. ⋯ Social quality of life and symptom relief measurements comprise the optimal set of independent factors that correlate most strongly with a response to opioid use in low back pain patients.
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Occupational health professionals must rely on the best available evidence in support of the appropriateness of diagnostic tests and preventive or clinical interventions. This study aims at comparing the decisions made in respect of health care personnel with the decisions made on the basis of the evidence and evaluating the effectiveness of these decisions. ⋯ Given that no gold standard exists and that guidelines for the management of back pain need to be assessed for their effectiveness, this study shows that the occupational health professional should be aware of the availability of up-to-date scientific evidence which can provide appropriate solutions to the commonly encountered problems. This perspective will be a challenge for professionals aware of the need to adopt practices related to the concept of quality in occupational health care.