Articles: low-back-pain.
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Reg Anesth Pain Med · Sep 2006
Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control.
For diagnostic lumbar medial-branch blocks, fluoroscopic guidance is considered mandatory, but this technique comes with radiation exposure. The clinical feasibility of the ultrasound-guided lumbar medial-branch block has been demonstrated. We evaluated the success rate and validity of this new method by use of fluoroscopy controls in patients previously diagnosed with lumbar facet joint-mediated pain. ⋯ Ultrasound-guided lumbar medial-branch blocks can be performed with a high success rate. However, to be completely independent from fluoroscopy controls, this technique requires further studies regarding the detection of intravascular spread.
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To report the middle term results of partial coccygectomy in a consecutive series of 15 patients with chronic coccygodynia. ⋯ Partial coccygectomy is a good therapeutic option for posttraumatic coccygodynia. Dynamic radiography is a useful tool to differentiate posttraumatic from idiopathic coccygodynia. MRI may be useful for further evaluation of the patients after inconclusive dynamic radiography.
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It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all. ⋯ MC constitutes the crucial element in the degenerative process around the disc in relation to LBP, history, and clinical findings. People with DD and no MC only vaguely differ from those without. People with LBP and MC may deserve to be diagnosed as having specific LBP.
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Randomized Controlled Trial Comparative Study
Interferential and horizontal therapies in chronic low back pain: a randomized, double blind, clinical study.
Chronic Low Back Pain (CLBP) is one of the most frequent medical problems. Electrical nerve stimulation is frequently used but its efficacy remains controversial. ⋯ This randomized double-blind controlled study provides the first evidence that IFT and HT therapy are significantly effective in alleviating both pain and disability in patients with CLBP. The placebo effect is remarkable at the beginning of the treatment but it tends to vanish within a couple of weeks.
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Comparative Study
[Central pain processing in chronic low back pain. Evidence for reduced pain inhibition].
A study of patients with low back pain (LBP) had revealed altered central pain processing. At an equal pain level LBP patients had considerably more neuronal activation in the somatosensory cortices than controls. In a new analysis of this dataset, we further investigated the differences in central pain processing between LBP patients and controls, looking for possible pathogenic mechanisms. ⋯ These findings support a dysfunction of the inhibitory systems controlled by the PAG as a possible pathogenic mechanism in chronic low back pain.