Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study
Prospective, randomized, single-blind, sham treatment-controlled study of the safety and efficacy of an electromagnetic field device for the treatment of chronic low back pain: a pilot study.
To evaluate the efficacy and safety of therapeutic electromagnetic fields (TEMF) on chronic low back pain. Secondary objectives included the investigation of the effects of TEMF on psychometric measures. ⋯ This study demonstrates that TEMF may be an effective and safe modality for the treatment of chronic low back pain disorders. More studies are needed to test this hypothesis.
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Randomized Controlled Trial Comparative Study
Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial.
Practice guidelines recommend various types of exercise and manipulative therapy for chronic back pain but there have been few head-to-head comparisons of these interventions. We conducted a randomized controlled trial to compare effects of general exercise, motor control exercise and manipulative therapy on function and perceived effect of intervention in patients with chronic back pain. Two hundred and forty adults with non-specific low back pain 3months were allocated to groups that received 8weeks of general exercise, motor control exercise or spinal manipulative therapy. ⋯ The motor control exercise group had slightly better outcomes than the general exercise group at 8weeks (between-group difference: PSFS 2.9, 95% CI: 0.9-4.8; GPE 1.7, 95% CI: 0.9-2.4), as did the spinal manipulative therapy group (PSFS 2.3, 95% CI: 0.4-4.2; GPE 1.2, 95% CI: 0.4-2.0). The groups had similar outcomes at 6 and 12months. Motor control exercise and spinal manipulative therapy produce slightly better short-term function and perceptions of effect than general exercise, but not better medium or long-term effects, in patients with chronic non-specific back pain.
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Randomized Controlled Trial
Physiotherapy-based rehabilitation following disc herniation operation: results of a randomized clinical trial.
Three-group, randomized, single blinded, controlled trial. ⋯ As compared with no therapy, physiotherapy following first-time disc herniation operation is effective in the short-term. Because of the limited benefits of physiotherapy relative to "sham" therapy, it is open to question whether this treatment acts primarily physiologically in patients following first-time lumbar disc surgery, but psychological factors may contribute substantially to the benefits observed.
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Comparative Study
Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use.
Retrospective cohort study of workers' compensation (WC) claims with acute disabling low back pain (LBP). ⋯ Given the negative association between receipt of early opioids for acute LBP and outcomes, it is suggested that the use of opioids for the management of acute LBP may be counterproductive to recovery.
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The surgical decompression of a symptomatic lumbar nerve root is generally regarded as effective treatment for radiculopathy. Nevertheless this straightforward surgical procedure is not universally successful, and the results are often independent of technical factors. ⋯ Although psychosocial issues (psychiatric factor, personal injury litigation, compensation claim) are well known to affect outcome, the strength and magnitude of their negative effects was surprising. The short form McGill Pain Questionnaire can be used not only as an outcome tool, but also as a predictor of result. The pain drawing has similar utility, but it should not be used as a substitute for psychiatric evaluation. The numerous issues exerting profound effects on the outcome of a relatively simple operation suggest that specific attention be directed at them when evaluating more complex surgical procedures. Although large randomized samples might obviate this concern, it is possible that some of these factors are too powerful to be ignored.