Articles: low-back-pain.
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Review Meta Analysis Comparative Study
Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies.
Low back pain is a costly illness for which spinal manipulative therapy is commonly recommended. Previous systematic reviews and practice guidelines have reached discordant results on the effectiveness of this therapy for low back pain. ⋯ There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain.
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Obesity and low back pain (LBP) are common health problems among patients attending Primary Health Care (PHC) in general practice at the United Arab Emirates (UAE). The objective of this study was to determine whether obesity is associated with low back pain. A cross-sectional face-to-face interview questionnaire survey was conducted. ⋯ Back pain had more influence on the life style habits on females than in males. Stepwise multiple regression analysis showed that only age (p < 0.0001), educational level (p = 0.001), gender (p = 0.002), place of living (p = 0.019), BMI (p < 0.0001), and housing condition (p = 0.02) had significant effect on the presence of LBP in patients. The present study showed that obesity is moderately associated with low back pain.
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Neuropathic low back pain is examined from a structural standpoint, distinguishing processes that start from chronic inflammation and mechanical compromise and cross into the realm of neuropathy with primary neurogenic pathophysiology. The disease of chronic pain is discussed, examining peripheral and central changes in neuroanatomy, neurophysiology, and neuromolecular dynamics. The limitations of inadequate random controlled trials regarding long-term pharmacologic interventions are contrasted with excellent work in the basic science of chronic pain. Complex rational pharmacologic strategies for structural pathology, central pain processes, sites of medication action, and differing routes of administration are delineated.
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Clinical Trial
Skeletal scintigraphy of young patients with low-back pain and a lumbosacral transitional vertebra.
Lumbosacral transitional vertebrae can alter the biomechanics of weight transfer at the affected spinal segment. Low-back pain may result. This study assessed what skeletal scintigraphy reveals about stress associated with a lumbosacral transitional vertebra in young patients with low-back pain. ⋯ Skeletal scintigraphy often indicates stress at the transverse-sacral articulation of young patients with low-back pain and a lumbosacral transitional vertebra. Showing evidence of stress is best accomplished using SPECT. Changes are usually not radiographically evident, but there is a trend for MRI and CT to show findings that imply stress or motion at the articulation. The unique ability of skeletal scintigraphy to provide this physiologic information supports its use in these patients.
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Percutaneous neuromodulation therapy (PNT) is a new minimally invasive, office-based treatment for low back pain in which electrical stimulation is delivered to the paraspinal peripheral nerves. The purpose of this study was to determine the safety, tolerability, and clinical efficacy of PNT in a population of patients with subacute low back pain with radiation to the lower extremity. ⋯ For many patients with subacute radiating low back pain, PNT significantly reduced pain and self-rated disability, and improved sleep quality and activity level. PNT is safe and generally well tolerated.