Articles: low-back-pain.
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G Ital Med Lav Ergon · Apr 2005
[A new method of functional rehabilitation of patients with occupational disability caused by lumbar spine pathology].
Rehabilitation is reducing disability through an improvement of function, i.e. rehabilitation need always to be "functional". Nevertheless, like it happened in other fields where rehabilitation has not yet reached its maturity, in spinal pathologies it has usually been considered equal to conservative treatment, i.e. not surgical relief of pain. But relieving pain does not always mean to recover function: in fact, it has been proven that there are no long term good results treating symptomatically chronic low back pain (CLBP). ⋯ This treatment, named "functional rehabilitation", proved its efficacy also in randomised controlled trials (RCT). In the Nineties in Finland the outpatient version of this treatment for CLBP has been developed by "Documentation Based Care" (DBC), whose efficacy have also been documented in RCT: the efficiency of this last kind of treatment should be higher. DBC treatment is spreading around the world, and it recently reached Italy in Don Gnocchi.
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Retrospective outcome measurement after circumferential reconstructive surgery with lumbar fusion in patients with chronic discogenic low back pain. ⋯ When using strict patient selection criteria that include independent determination of pain generators via pressure-controlled diskography and completion of a preoperative conditioning program for improving general health status, the number of levels in reconstructive lumbar surgery may not significantly impact overall clinical outcome.
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Randomized Controlled Trial Multicenter Study
Implementation of the Dutch low back pain guideline for general practitioners: a cluster randomized controlled trial.
Cluster randomized controlled trial for a multifaceted implementation strategy. ⋯ The multifaceted intervention strategy modestly improved implementation (for parts of the recommendations in) the Dutch low back pain guideline by general practitioners and produced small concomitant changes in patient management. The implementation strategy produced fewer referrals to therapists during follow-up consultations.
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Systematic review. ⋯ NRT appears to be a safe and effective intervention for nonspecific LBP. This conclusion is limited to three trials conducted by a small number of experienced clinicians. Further trials in other settings are needed to determine whether these favorable results can be generalized.
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Review Comparative Study
The updated cochrane review of bed rest for low back pain and sciatica.
A systematic review within the Cochrane Collaboration Back Review Group. ⋯ For people with acute low back pain, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active.