Articles: low-back-pain.
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J Manipulative Physiol Ther · Mar 2007
Case ReportsTwenty-year-old pathogenic "active" postsurgical scar: a case study of a patient with persistent right lower quadrant pain.
This case study describes a patient with persistent right lower quadrant and low back pain who experienced relief after manual mobilization techniques of an old appendectomy scar. ⋯ Assessment and treatment of "active" scar tissue may comprise an important component of the management of locomotor dysfunction and associated pain syndromes.
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Facet syndrome is persistent low back pain that might be treated with some surgical interventions. The target of surgical techniques is the transverse process bases where the medial nerve branches innervated the facet. However, highly variable success rates have been demonstrated in different series. ⋯ The dorsal surface of the facet capsule might be a more preferable target for facet denervation.
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Clinical Trial
Radiofrequency denervation of the lumbar zygapophysial joints: 10-year prospective clinical audit.
Evidence for the efficacy of zygapophysial joint nerve radiofrequency neurotomy has remained controversial. Two randomized controlled trials showed positive results, but two others demonstrated no benefit. One carefully performed prospective trial confirmed high efficacy and lasting pain relief after the procedure; however, selection criteria for this study were superfluous, which resulted in a small number of patients available for follow up. ⋯ This large, prospective clinical audit indicates that proper patient selection and anatomically correct radiofrequency denervation of the lumbar zygapophysial joints provide long-term pain relief in a routine clinical setting.
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Multicenter Study
Psychosocial variables in patients with (sub)acute low back pain: an inception cohort in primary care physical therapy in The Netherlands.
A prospective cohort study of patients with episodes of acute or subacute low back pain, seeking physical therapy in primary care, with follow-up at weeks 2, 4, 8, and 12. ⋯ The study strongly revealed pain-related items to be essential factors in the development of chronicity and long-term disability in primary care physical therapy. Health status at 8 weeks seems crucial in developing chronicity.
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Psychological factors are assumed to predict persistent or recurrent musculoskeletal pain. The influence of psychological factors in patients with low-back pain (LBP) or shoulder pain was explored to study whether there is similarity regarding the factors that predict persisting pain and disability. ⋯ Psychological factors, with the exception of fear-avoidance beliefs, are more strongly associated with persistent pain and disability in patients with LBP than in those with shoulder pain. This seems to indicate that in a primary care population the influence of psychological factors on outcome may vary across patients with different types of pain.