Articles: low-back-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain randomized to lumbar fusion or cognitive intervention and exercises.
A randomized study. ⋯ Patients with chronic low back pain who followed cognitive intervention and exercise programs improved significantly in muscle strength compared with patients who underwent lumbar fusion. In the lumbar fusion group, density decreased significantly at L3-L4 compared with the exercise group.
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Prolotherapy is an injection-based treatment for chronic low-back pain. Proponents of prolotherapy suggest that some back pain stems from weakened or damaged ligaments. Repeatedly injecting them with irritant solutions is believed to strengthen the ligaments and reduce pain and disability. Prolotherapy protocols usually include co-interventions to enhance the effectiveness of the injections. ⋯ There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low-back pain. Conclusions are confounded by clinical heterogeneity amongst studies and by the presence of co-interventions. There was no evidence that prolotherapy injections alone were more effective than control injections alone. However, in the presence of co-interventions, prolotherapy injections were more effective than control injections, more so when both injections and co-interventions were controlled concurrently.
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The factor structure, reliability and validity of the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) were determined in the current study. Furthermore, the ability of the HC-PAIRS to serve as a predictor for work and activity recommendations of paramedical health care providers was examined. ⋯ The HC-PAIRS appears to be a reliable and valid measure of health care providers' attitudes and beliefs about the relationship between pain and impairment. The role of health care providers' attitudes in the treatment of low back pain is discussed.
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Multicenter Study Clinical Trial
Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain Scale.
To determine the impact of the lidocaine patch 5% on pain qualities associated with chronic pain from postherpetic neuralgia (PHN), painful diabetic neuropathy (DN), and low-back pain (LBP), using the Neuropathic Pain Scale (NPS). ⋯ The lidocaine patch 5% effectively reduces the intensity of all common pain qualities in patients with moderate-to-severe chronic pain resulting from PHN, painful DN, or LBP. Treatment is well tolerated in combination with other analgesic regimens, with no reports of serious AEs or adverse drug interactions. Assessment scales such as the NPS may offer the possibility to differentiate between various pain states and to assess treatment outcomes for various pain qualities associated with a given pain state.
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To evaluate accuracy of needle placement and flow patterns of fluoroscopically guided caudal epidural injections. ⋯ Caudal epidural injections are ideally performed with fluoroscopic guidance as the gold standard for accurate needle placement. However, this does not assure either targeted delivery or accurate placement of the drug.