Articles: low-back-pain.
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To identify core elements of what patients with chronic low back pain perceive as good clinical communication and interaction with a specialist ("The Good Back-Consultation"). ⋯ The findings may represent an important potential for enhancing clinical communication with patients.
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Nat Clin Pract Rheum · Jul 2006
Randomized Controlled TrialDoes flexion-distraction help treat chronic low back pain?
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Radiofrequency neurotomies are used to help reduce pain caused by structures innervated by the medial branch of the dorsal spinal nerve. The duration of effect may vary proportionally to the length of nerve coagulated. Techniques used to maximize the length of nerve within the radius of maximal heat include making multiple lesions, using larger needles, positioning the exposed needle parallel to the target nerve, and attempting more precise placement using 50 hertz test stimulation. A variation of the technique uses two needles that are simultaneously placed to lie parallel to one another and parallel to the probable area the target nerve is known to traverse. Heating both needles at the same time would be a faster method that theoretically might also include more tissue within the heating radius of the needle lengths. ⋯ This research confirms the efficacy of utilizing two needle electrodes during lumbar facet rhizotomy in an experimental model. Heating the two electrodes sequentially appears to coagulate a wider area and thus would be more likely to include a longer length of the target nerve and thus potentially could achieve better results in less time.
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Prospective cohort study. ⋯ Poor overall physical function and depression symptomatology are associated with LBP and consequences of LBP in persons 70 years of age and older.
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Systematic review. ⋯ Based on the current evidence, intermittent or continuous traction as a single treatment for LBP cannot be recommended for mixed groups of patients with LBP with and without sciatica. Neither can traction be recommended for patients with sciatica because of inconsistent results and methodological problems in most of the studies involved. However, because high-quality studies within the field are scarce, because many are underpowered, and because traction often is supplied in combination with other treatment modalities, the literature allows no firm negative conclusion that traction, in a generalized sense, is not an effective treatment for patients with LBP.