Articles: low-back-pain.
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Reg Anesth Pain Med · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialRadiofrequency lumbar facet denervation: a comparative study of the reproducibility of lesion size after 2 current radiofrequency techniques.
Radiofrequency facet denervation procedures are widely used for the treatment of chronic low-back pain. Currently, both temperature-controlled and voltage-controlled techniques are used. In this combined in vivo and in vitro study, the electrophysiologic consequences and the effects on lesion size of these techniques were determined. ⋯ There is no consistent relation between voltage and the temperature obtained during radiofrequency lumbar facet denervation. Temperature-controlled radiofrequency lesioning is preferred to create reproducible lesion sizes.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized controlled trial of intensive neurophysiology education in chronic low back pain.
Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. ⋯ Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.
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Multicenter Study Comparative Study
The effect of previous low back surgery on general health status: results from the National Spine Network initial visit survey of patients with low back pain.
A cross-sectional study on 18,325 patients with back pain enrolled at first visit in the National Spine Network (NSN) database from January 1998 to April 2000. ⋯ Previous back surgery is associated with significantly worse general health status than those without surgery. Among patients who had previous surgeries, decompression seems to exert better effects on SF-36 health status. There is a positive correlation between time since last surgery and the SF-36 outcomes, although the SF-36 scores are significantly lower than those without previous surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Endogenous opioids and chronic pain intensity: interactions with level of disability.
To test whether endogenous opioid antinociceptive system dysfunction evidenced in response to acute pain stimuli is associated with increased clinical pain intensity in chronic pain sufferers, and to determine whether this association is moderated by disability level. ⋯ These results suggest that endogenous opioid antinociceptive system dysfunction may contribute to elevated acute and chronic pain sensitivity among more disabled chronic pain patients. Among less disabled patients, chronic pain may serve as a primer producing up-regulated opioid antinociceptive responses to acute pain
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Clinical therapeutics · Sep 2004
Review Comparative StudyCommonly used muscle relaxant therapies for acute low back pain: a review of carisoprodol, cyclobenzaprine hydrochloride, and metaxalone.
Low back pain is a leading reason for primary care visits. Many treatment options are available, but some lack scientific support. ⋯ Analgesic pain management for low back pain due to muscle spasm may be combined with a muscle relaxant. Cyclobenzaprine hydrochloride has the most recent and largest clinical trials demonstrating its benefit, but carisoprodol and metaxalone also appear to be effective. However, carisoprodol's usefulness is mitigated by its potential for abuse.