Articles: low-back-pain.
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Ann Readapt Med Phys · May 2008
[Short- and midterm effectiveness of a back school. Retrospective cohort study on 328 patients with chronic low back pain from 1997 to 2004].
To assess the short- and midterm effects of a back school programme on patients with chronic low back pain. To determine positive factors to the effectiveness of back school. ⋯ Even if the number of lost to follow up is high, these results are encouraging. A long-term follow-up is necessary to confirm the initial benefits of back school. We although have to assess the role of physical activity in mid-term effectiveness of this back school.
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AJNR Am J Neuroradiol · May 2008
Randomized Controlled Trial Controlled Clinical TrialValue of diagnostic lumbar selective nerve root block: a prospective controlled study.
Although diagnostic lumbar selective nerve root blocks are often used to confirm the pain-generating nerve root level, the reported accuracy of these blocks has been variable and their usefulness is controversial. The purpose of this study was to evaluate the accuracy of diagnostic lumbar selective nerve root blocks to analyze potential causes of false results in a prospective, controlled, single-blinded manner. ⋯ The accuracy of diagnostic lumbar selective nerve root blocks is only moderate. To improve the accuracy, great care should be taken to avoid inadequate blocks and overflow, and to precisely interpret spot radiographs.
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Bed rest has been shown to be an ineffective treatment for non-specific low back pain (LBP). Despite this, during a new episode of pain some patients still rely on bed rest. Which patients choose bed rest is however unknown. ⋯ Patients with prolonged bed rest in an early phase of pain were still more disabled after one year (p<0.01). Based on these results we conclude that prolonged bed rest in the early phase of pain is associated with a higher long term disability level. In preventing low back disability, GP screening for catastrophizing and fear of injury in LBP patients who had prolonged bed rest merits consideration.
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Multicenter Study
Lumbar zygapophysial (facet) joint radiofrequency denervation success as a function of pain relief during diagnostic medial branch blocks: a multicenter analysis.
The publication of several recent studies showing minimal benefit for radiofrequency (RF) lumbar zygapophysial (l-z) joint denervation have led many investigators to reevaluate selection criteria. One controversial explanation for these findings is that the most commonly used cutoff value for selecting patients for l-z (facet) joint RF denervation, greater than 50% pain relief after diagnostic blocks, is too low and hence responsible for the high failure rate. ⋯ Using more stringent pain relief criteria when selecting patients for l-z joint RF denervation is unlikely to improve success rates, and may lead to misdiagnosis and withholding a potentially valuable treatment from good candidates.
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AJNR Am J Neuroradiol · May 2008
ReviewThe modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine.
Two decades following their description, the significance of Modic vertebral endplate and marrow changes remains a matter of debate. These changes are closely related to the normal degenerative process affecting the lumbar spine, and their prevalence increases with age. However, the exact pathogenesis underlying these changes and their relation to segmental instability of the lumbar spine and to low back pain remain unclear. In this paper, we review the literature relevant to this topic and discuss the currently available evidence regarding the pathologic and clinical significance of Modic changes.