Articles: low-back-pain.
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(1) Chronic lumbar (lower back) pain, which affects many Canadians, imposes a large economic burden. (2) Symptoms may occur in the vertebral facet joints of 15% to 40% of patients with lower back pain. (3) Medial branch radiofrequency neurotomy is a minimally invasive outpatient procedure that reduces pain by interrupting the nerve supply to painful facet joints. (4) Four systematic reviews of this procedure offer disparate conclusions. (5) One small well designed observational study has shown positive results, but no equally rigorous randomized controlled trial has been conducted.
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Randomized Controlled Trial
The association between psychopathology and placebo analgesia in patients with discogenic low back pain.
Chronic low back pain patients have a high rate of psychopathology, comprised mainly of depression, anxiety, and high levels of neuroticism. We previously found that psychopathology is associated with increased placebo analgesia in this patient group. ⋯ This study indicates that high and moderate levels of psychopathology are associated with heightened placebo analgesia in chronic low back pain patients. Expectations were only an influence in the high psychopathology group, and neuropathic pain affects placebo responses. These findings have implications for future research characterizing placebo responders.
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Multicenter Study
Predicting persistent disabling low back pain in general practice: a prospective cohort study.
Patients may adopt active and/or passive coping strategies in response to pain. However, it is not known whether these strategies may also precede the onset of chronic symptoms and, if so, whether they are independent predictors of prognosis. ⋯ Patients who report passive coping strategies experience a significant increase in the risk of persistent symptoms. Further, this risk persists after controlling for initial pain severity and disability. The identification of this low back pain subgroup may help target future treatments to those at greatest risk of a poor outcome.
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Ann Readapt Med Phys · May 2006
Comparative Study[Validity and reliability of Spinal Mouse to assess lumbar flexion].
To evaluate the validity and reliability of the Spinal Mouse model to assess lumbar spine flexion. ⋯ The Spinal Mouse has acceptable metrological properties to assess segmental and global lumbar mobility during trunk flexion. Its metrological properties are not acceptable to assess mobility of L5-S1.
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J Spinal Disord Tech · May 2006
Controlled Clinical TrialMicrosurgical treatment of juxta facet cysts of the lumbar spine.
Juxta facet cysts are a common cause of low back and radicular pain. They are mostly associated with degenerative facet joints and spondylolisthesis. The study focuses on long-term outcomes after microsurgical treatment without fusion. ⋯ Conservative therapy does not adequately improve symptoms in patients with intraspinal juxta facet cysts and radicular signs. Juxta facet cysts can be treated effectively with a minimally invasive microsurgical approach. This may be of particular significance when the cysts are associated with spondylolisthesis, minimizing the risk of instability and the need for fusion. In a selected group of patients with persistent low back pain, fusion may become necessary to improve symptoms.