Articles: low-back-pain.
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Comparative Study
Intradiscal electrothermal therapy (IDET) for chronic low back pain in active-duty soldiers: 2-year follow-up.
Intradiscal electrothermal therapy (IDET) is a new treatment option for chronic discogenic low back pain that is minimally invasive and has demonstrated success rates equal to or better than those for spinal fusion at short-term follow-up. ⋯ IDET is not a substitute for spinal fusion in the treatment of chronic discogenic low back pain in active-duty soldiers. Our reasonable early results diminished with time and up to 20% of patients report worsening of baseline symptoms at final follow-up. IDET will prove its role in the treatment of chronic discogenic low back pain as more outcome data are obtained, but for now we consider it, at best, an antecedent rather than alternative to spinal fusion.
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Comparative Study
Correlation of clinical examination characteristics with three sources of chronic low back pain.
Research has demonstrated some progress in using a clinical examination to predict discogenic or sacroiliac (SI) joint sources of pain. No clear predictors of symptomatic lumbar zygapophysial joints have yet been demonstrated. ⋯ Significant correlations exist between clinical examination findings and symptomatic lumbar discs, zygapophysial and SI joints. The strongest relationships were seen between SI joint pain and three or more positive pain provocation tests, centralization of pain for symptomatic discs and absence of pain when rising from sitting for symptomatic lumbar zygapophysial joints.
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Comparative Study
Compliance with clinical practice guidelines in family physicians managing worker's compensation board patients with acute lower back pain.
Family physician compliance with acute lower back pain clinical practice guidelines remains uncertain. ⋯ Recently published clinical practice guidelines regarding the management of patients with acute mechanical lower back pain have not been fully implemented into the patterns of practice of the family physicians.
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AJR Am J Roentgenol · Nov 2003
Comparative StudyEfficacy of epidural injections of Kenalog and Celestone in the treatment of lower back pain.
Epidural corticosteroid injections have been used extensively to treat lower back pain, but the relative effectiveness of one corticosteroid versus another has never been reported in a large patient series. We retrospectively reviewed 597 patients who had epidural corticosteroid injections to determine any difference in Kenalog or Celestone efficacy. ⋯ The epidural injection of Celestone Soluspan and Kenalog reduced lower back and radicular pain in more than half the patients, although Kenalog reduced pain in a significantly larger number of patients than Celestone Soluspan at 1 and 2 weeks after injection.
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Comment Letter Randomized Controlled Trial Clinical Trial
Re: Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine 2002; 27:2193-204.