Articles: low-back-pain.
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Comparative Study
The feasibility of color Doppler ultrasonography for caudal epidural steroid injection.
Although it entails a radiation hazard risk, the use of fluoroscopy during caudal epidural steroid injection has increased to help place the medication more accurately and allowed physicians to maximize the procedure's therapeutic success rate. To investigate the feasibility of using real-time high resolution ultrasonography for guiding the epidural needle into the caudal epidural space and to confirm any vascular intake of medication, we performed color Doppler ultrasonography while medication was being injected into the caudal epidural space of 53 patients with low back pain and sciatica. We defined the injection as being successful if unidirectional flow (observed as one dominant color) of the solution was observed with color Doppler ultrasonography through the epidural space beneath the sacrococcygeal ligament, with no flows being observed in other directions (observed as multiple colors). ⋯ In 52 of the 53 subjects, the medications were successfully injected into the caudal epidural space with ultrasonography assistance. In fluoroscopy, of these 52 patients, 50 revealed correct placement of the medicine into the epidural space. In conclusion, ultrasonography may be a reliable imaging modality for caudal epidural steroid injection, and its several advantages such as its convenience and the lack of a radiation hazard, make it preferable to fluoroscopy.
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To retrospectively determine if there is a difference in the effectiveness of triamcinolone acetonide injectable suspension versus betamethasone sodium phosphate and betamethasone acetate injectable suspension in the treatment of radiculopathy and low back pain with selective lumbar nerve blocks. ⋯ Selective nerve root blocks with betamethasone and triamcinolone reduced low back pain and lower extremity pain, although there was no significant difference in effectiveness between the two.
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MRI can be too sensitive for detecting degenerative changes and commonly displays pathology that is not necessarily responsible for the patient's symptoms. ⋯ HIZ is known to be a common lesion found using MRI in lower back pain patients. In operated segments, we found an incidence of 81.8% and in unoperated segments of 28.2%. Discography can discriminate between painful and non-painful discs. With the help of additional parameters such as contrast mean volume and pain characteristics during puncture, the number of false positive discograms can be reduced.
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A prospective cohort. ⋯ Lifetime prevalence of back pain increased sharply during nursing school but slowly after that. Back pain at entering the nursing school was a predictor for back-related pain and disability. Self- reported occupational physical work load was associated with back pain and related disability. The nature of the association is unclear, but it is likely that back pain is exacerbated during nursing.
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Randomized Controlled Trial Clinical Trial
Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.
We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting. ⋯ These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.