Articles: low-back-pain.
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Comparative Study
Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome?
We describe the illness perceptions of patients with low back pain, how they change over 6 months, and their associations with clinical outcome. Consecutive patients consulting eight general practices were eligible to take part in a prospective cohort study, providing data within 3 weeks of consultation and 6 months later. Illness perceptions were measured using the Revised Illness Perception Questionnaire (IPQ-R). ⋯ There were strong, statistically significant, associations (RRs of 1.4 and over) between IPQ-R baseline consequences, timeline acute/chronic, personal control and treatment control scores and poor outcome. Patients who expected their back problem to last a long time, who perceived serious consequences, and who held weak beliefs in the controllability of their back problem were more likely to have poor clinical outcomes 6 months after they consulted their doctor. These results have implications for the management of patients, and support the need to assess and address patients' cognitions about their back problems.
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Low back pain with sciatica is one of the most common complaints of patients presenting to the ED, and it is usually managed on an outpatient basis. However, acute lower back pain not always derives from a benign cause. We report here the case of a 63-year-old diabetic man who presented to the ED complaining of acute low back pain with sciatica and fever. The cause was a large paravertebral abscess by Streptococcus milleri, and this was the first presenting sign of an unknown underlying colonic cancer.
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Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. ⋯ This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back.
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Comparative Study
Aerobic fitness in patients at work despite recurrent low back pain: a cross-sectional study with healthy age- and gender-matched controls.
The aims of this study were to compare the aerobic fitness level of working patients who have recurrent low back pain with those of healthy age- and gender-matched controls, and to investigate the relationship of aerobic fitness level with pain intensity, general health, perceived disability, fear-avoidance beliefs and self-efficacy. ⋯ This study suggests no overall difference in predicted aerobic fitness level for a sample of subjects with recurrent low back pain compared with healthy controls. This is perhaps because all the patients were still at work despite the pain. The results indicate, however, that the factors associated with aerobic fitness differ between men and women.
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Neurological research · May 2008
Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study of 39 patients with the Oswestry disability index at 18 month follow-up.
The authors evaluate the efficacy of intradiscal electrothermal therapy (IDET) for discogenic pain on outcome of patients using the Oswestry disability index (ODI) after 18 month follow-up. ⋯ Although various alterations in outcome scores have been reported in previous works, we found nearly four in five patients (79.48%) who clearly benefited from this therapy. This procedure may become a middle step for carefully selected group of patients who failed non-operative treatment before surgical intervention.