Articles: low-back-pain.
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Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national clinical guidelines, much controversy still remains regarding the evidence for or against efficacy of spinal manipulation for low back pain and neck pain. ⋯ Our data synthesis suggests that recommendations can be made with some confidence regarding the use of SMT and/or MOB as a viable option for the treatment of both low back pain and NP. There have been few high-quality trials distinguishing between acute and chronic patients, and most are limited to shorter-term follow-up. Future trials should examine well-defined subgroups of patients, further address the value of SMT and MOB for acute patients, establish optimal number of treatment visits and consider the cost-effectiveness of care.
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Injection of 17-20 ml of local anesthetic combined with corticosteroids via hiatus canalis sacralis or epidural between spinal processes in the lumbar region leads to distribution up to the level of the thoracolumbar junction. The indication for therapeutic peridual or epidural injections are radicular symptoms as a result of disc herniation, foraminal stenosis as well as neurogenic claudication. ⋯ Complications and side effects occur extremely seldom. There is only one RCT for radiculopathy and epidural steroids.
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J Manipulative Physiol Ther · May 2004
Low back pain in Australian adults: prevalence and associated disability.
To determine the prevalence ranges of low back pain (LBP) together with any related disability in Australian adults. ⋯ LBP is a common problem in the Australian adult population, yet most of this is low-intensity and low-disability pain. Nevertheless, over 10% had been significantly disabled by LBP in the past 6 months. Data from this study will provide a better understanding of the magnitude of the LBP problem in Australia, the need for access to health care resources, and also strategic research directions.
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Randomized Controlled Trial Clinical Trial
Onset of pain relief with rofecoxib in chronic low back pain: results of two four-week, randomized, placebo-controlled trials.
We recently reported the efficacy of rofecoxib in two randomized controlled trials in chronic low back pain (CLBP). The objectives of this report are to present data regarding the onset of efficacy of rofecoxib from these trials and propose methods for reporting onset. ⋯ Approximately 2/3 of patients achieved meaningful pain relief with rofecoxib time to onset of meaningful relief was about 2 days, but superior relief over placebo was seen by bedtime after the first dose. Onset of perceptible pain relief was within 2 h. We propose that measures of onset of analgesic effect include the proportion of patients who achieve meaningful pain relief and in this subgroup, the time-to-onset of confirmed meaningful reduction in pain intensity, time-to-onset of confirmed pain relief, and time to first separation from placebo in the proportion of patients who achieve meaningful pain relief.
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Low back pain is common among nurses. Previous studies have shown that the risk of low back pain increases rapidly with greater amounts of physical work and psychological stress, but is inversely related to leisure activities. However, these previous studies were predominantly retrospective in design and not many took account of three factors simultaneously. ⋯ The findings of this study suggest that low back pain is a common problem in the population of nurses in Hong Kong. Being comparatively new on a ward, bending frequently during work and having poor work relationships with colleagues are independent predictors of new low back pain. Training for high-risk work activities and ergonomic assessment of awkward work postures are essential. Moreover, relaxation and team-building workshops for nurses, especially those who are less experienced in the type of work on their current ward, are recommended.