Articles: low-back-pain.
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Arch Phys Med Rehabil · Dec 2002
Case ReportsFluoroscopically guided aspiration of a symptomatic lumbar zygapophyseal joint cyst: a case report.
Lumbar zygapophyseal joint cysts are potential pain generators in patients with axial pain and/or lower-limb radicular pain. The traditional treatment of symptomatic cysts that do not respond to conservative measures is surgical decompression. Percutaneous needle aspiration under fluoroscopic guidance is a potential minimally invasive treatment option. We present a patient with a large symptomatic L4-5 zygapophyseal joint cyst and right L5 radiculopathy who responded well to percutaneous aspiration.
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Retrospective literature review. ⋯ The studies published so far suggest that the pain resulting from lumbar disc disease may be diminished by intradiscal electrothermal annuloplasty. All these studies project a positive therapeutic effect. However, all the studies suffer from the same methodologic flaws. A prospective cohort design or a nonrandomized prospective design is used with a biased control. The scientific validity of various study designs is discussed, and a randomized prospective study is recommended. Additionally, more investigation into the basic science of the action of intradiscal electrothermal annuloplasty is required.
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Arch Phys Med Rehabil · Nov 2002
Clinical Trial Controlled Clinical TrialChanges in sagittal lumbar configuration with a new method of extension traction: nonrandomized clinical controlled trial.
To determine if a new method of lumbar extension traction can increase lordosis in chronic low back pain (LBP) subjects with decreased lordosis. ⋯ This new method of lumbar extension traction is the first nonsurgical rehabilitative procedure to show increases in lumbar lordosis in chronic LBP subjects with hypolordosis. The fact that there was no change in control subjects' lumbar lordosis indicates the stability of the lumbar lordosis and the repeatability of x-ray procedures. Because, on average, chronic LBP patients have hypolordosis, additional randomized trials should be performed to evaluate the clinical significance of restoration of the lumbar lordosis in chronic LBP subjects.
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To evaluate the measurement properties of the Revised Oswestry Disability Questionnaire (RODQ) by using rating scale analyses. ⋯ By using the abbreviated scale, suggested item order, and predicted responses, abbreviated versions of the instrument can be applied to measure LBP-D more efficiently.
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Clinical Trial Controlled Clinical Trial
The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: the effects of opioid blockade.
Resting blood pressure is inversely correlated with acute pain sensitivity in healthy normotensives. This study tested: (1) whether endogenous opioid activity is necessary for this adaptive relationship to occur, (2) whether this relationship is altered in chronic low back pain (LBP), and (3) whether endogenous opioid dysfunction underlies any such alterations. Fifty-one pain-free normotensives and 44 normotensive chronic LBP sufferers received opioid blockade (8 mg naloxone i.v.) or placebo blockade (saline) in randomized, counterbalanced order in separate sessions. ⋯ Opioid blockade exerted no significant main or interaction effects in these combined groups analyses (p values >0.10). Higher DBP was associated with greater clinical pain intensity among the LBP subjects (P<0.001). Overall, these results suggest: (1) endogenous opioids do not mediate the inverse relationship between resting blood pressure and acute pain sensitivity in pain-free normotensives; (2) the BP-pain sensitivity relationship is altered in chronic pain, suggesting dysfunction in pain regulatory systems, and (3) these alterations are not related to opioid dysfunction.