Articles: low-back-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Acupuncture for chronic low back pain in older patients: a randomized, controlled trial.
To determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain (LBP) in older patients. ⋯ Acupuncture is an effective, safe adjunctive treatment for chronic LBP in older patients.
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Descriptive prognostic study. ⋯ Age and intensity of pain are the strongest predictors of outcome. Accumulation of days on sick leave is predicted by the duration of sick leave at entry and the type of work, but not by pain, perceived disability, or satisfaction with work.
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Randomized Controlled Trial Clinical Trial
Importance of the back-café concept to rehabilitation after lumbar spinal fusion: a randomized clinical study with a 2-year follow-up.
A prospective, randomized, clinical study with a 2-year follow-up. ⋯ The patients in the back-café group were significantly better at accomplishing a succession of daily tasks compared with the video and training groups 2 years after lumbar spinal fusion. At the 2-year follow-up the training group had a significant pain problem compared with the video and back-café groups. The video group had significantly more treatment demands outside the hospital system. This study demonstrates the relevance of the inclusion of coping schemes and questions the role of intensive exercises in a rehabilitation program for spinal fusion patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction.
Recent work suggests that an expressive anger management style (anger-out) is associated with elevated acute pain sensitivity due to endogenous opioid antinociceptive dysfunction. We tested the hypothesis that this opioid dysfunction mediates the previously reported positive association between anger-out and chronic pain intensity. To assess endogenous opioid antinociception in the laboratory, 71 subjects with chronic low back pain received opioid blockade (8 mg naloxone i.v.) or placebo in counterbalanced order in separate sessions. ⋯ Inclusion of blockade effects in the first step of the regression resulted in a decrease from 7 to 3% in chronic pain variance accounted for by anger-out. Opioid dysfunction did not mediate the positive association between anger-in and chronic pain. These results provide preliminary support for the hypothesis that the positive association between anger expression and chronic pain intensity is mediated by opioid antinociceptive system dysfunction.
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To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. ⋯ Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.