Articles: low-back-pain.
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Clinical rehabilitation · Jul 2007
Multicenter StudySensitivity, specificity and predictive value of the clinical trunk muscle endurance tests in low back pain.
To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of five clinical tests used to measure trunk muscle endurance in low back pain. ⋯ It seems that the prone double straight-leg raise test has more sensitivity, specificity and predictive value in low back pain than other tests and could be used as a useful clinical method for testing the spinal muscle endurance to predict the probability of the occurrence of low back pain.
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Randomized Controlled Trial
A double-blind, placebo-controlled, dose-response pilot study evaluating intradiscal etanercept in patients with chronic discogenic low back pain or lumbosacral radiculopathy.
In recent years, convincing evidence has emerged implicating tumor necrosis factor alpha as a causative factor in radiculopathy and discogenic back pain. But although preliminary open-label studies demonstrated promising results for the treatment of low back pain with tumor necrosis factor-alpha inhibitors, early optimism has been tainted by a controlled study showing no significant benefit in sciatica. To determine whether outcomes might be improved by a more direct route of administration, the authors evaluated escalating doses of intradiscal etanercept in 36 patients with chronic lumbosacral radiculopathy or discogenic low back pain. ⋯ Although no serious side effects were observed in this small study, a single low dose of intradiscal etanercept does not seem to be an effective treatment for chronic radicular or discogenic low back pain.
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The purpose of this study was to analyze the association between the severity of inflammatory endplate changes (Modic) on MRI and the clinical response to intradiscal injection of corticosteroids (IDIC) in chronic low back pain (LBP). A total of 74 patients with LBP and inflammatory Modic changes who showed no response to 3-month conservative treatment received lumbar IDIC. Two spine specialists and a radiologist assessed independently the endplate marrow changes of the injected discs. ⋯ At 3 and 6 months, IDIC tended to be more effective in the Modic I and Modic I-2 groups but not significantly. No complications such as infection or hematoma were reported. IDIC could be a short-term efficient treatment for patients with chronic LBP and predominantly inflammatory endplate changes when conservative treatments have failed.
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J Manipulative Physiol Ther · Jul 2007
Responsiveness of the short-form 36 and oswestry disability questionnaire in chronic nonspecific low back and lower limb pain treated with customized foot orthotics.
This study reports the responsiveness of the Short-Form 36 (SF-36) and Oswestry Disability Questionnaire (ODQ) to treatment with customized foot orthotics. ⋯ In this cohort, the ODQ and the physical component of the SF-36 appear to be responsive to treatment effects, with the ODQ having the highest responsiveness. The ODQ may be a useful outcome measure in trials of the effectiveness of customized foot orthotics in patients with nonspecific, chronic low back and/or soft tissue lower limb pain.
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Objective. Our objective was to determine the efficacy of peripheral nerve field stimulation (PNFS) for the treatment of chronic lower back pain. PNFS is becoming increasingly recognized as a safe, minimally invasive, and easily reversible treatment for a variety of chronic pain conditions. Chronic low back pain is a common cause of disability and one that is difficult to treat effectively. ⋯ Results. In each case presented here, PNFS enabled patients to decrease their pain medication and increase their level of activity. The patients all reported reduction in pain as measured by visual analog scale scores and an improved quality of life. Conclusion. We conclude that PNFS is a safe and effective alternative treatment for patients with chronic low back pain, and should be considered in this population.