Articles: low-back-pain.
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Arch Orthop Trauma Surg · Jan 2000
Radiographic analysis of lumbar spine for low-back pain in the general population.
We sought to demonstrate a correlation between low-back pain (LBP) and the plain radiographic findings of the lumbar spine in the general population based on an analysis of 838 persons, 387 of whom presented with complaints of low-back pain. The incidence of intervertebral narrowing and irregular ossification of the vertebral end-plate image increased consistently with age and was higher in the presence of LBP in any age or gender group. Multiregression analysis was performed with the imaging factors as multivariates. ⋯ The discrimination analysis was performed using the linear discriminant function, resulting in a true discrimination rate of 65%. Plain radiography of the lumbar spine is thus significant as it provides information which can be evaluated as meaningful findings in the investigation of LBP. In addition, while the significance can be increased by considering multiple factors, it is important to understand the limits of the accuracy of this prediction.
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Historical Article
Validation of the German version of the Fear-Avoidance Beliefs Questionnaire (FABQ).
Fearful avoidance of physical activities is a major factor in low back pain (LBP) and disability. In 1993 Waddell et al. developed the Fear-Avoidance Beliefs Questionnaire (FABQ) focusing on patients' beliefs about how physical activity and work affect LBP. The focus of our study was to analyse and validate the German version of the FABQ. ⋯ Patients out of work demonstrated more fear-avoidance beliefs in comparison to those who were still working. It can be concluded that the German version of the FAQB is a reliable and valid instrument, but it shows a different factor structure from the original English version. The FABQ has been proven to identify patients with maladaptive beliefs which have to be focused on in proper treatment.
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Percutaneous epidural adhesiolysis, lysis of epidural adhesions, percutaneous neuroplasty, or epidural neurolysis is an interventional pain management technique which emerged during the latter part of the 1980s. It is becoming established as a common treatment modality in managing chronic low back pain that is nonresponsive to other modalities of treatment. ⋯ Percutaneous lysis of epidural scar tissue, followed by the injection of hypertonic saline neurolysis, has been shown to be cost effective in multiple studies. This review discusses various aspects of percutaneous nonendoscopic adhesiolysis and hypertonic saline neurolysis including clinical effectiveness, complications, rationale, and indications.
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Cochrane Db Syst Rev · Jan 2000
ReviewMultidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults.
Multidisciplinary biopsychosocial rehabilitation programs are widely applied for chronic low back pain patients. The biopsychosocial approach for low back pain could also be considered to prevent chronicity by carrying out the rehabilitation if the acute pain is prolonged. Nevertheless multidisciplinary treatment programmes are often laborious and long processes and require good collaboration between the patient, the rehabilitation team and the work place. By workplace visits and close relationship with occupational health care one might expect results in terms of patients working ability. ⋯ We conclude that there is moderate evidence of positive effectiveness of multidisciplinary rehabilitation for subacute low back pain and workplace visit increases the effectiveness. But because this evidence is based on the trials that had some methodological shortcomings and several expensive multidisciplinary rehabilitation programmes are commonly used for common subacute low back problems, there is an obvious need for high quality trials in this field.
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Since the introduction of the Swedish back school in 1980, the content of back schools has changed and appears to vary widely today. Back schools are frequently used in the treatment of low back pain patients. ⋯ Back schools may be effective for patients with recurrent and chronic low back pain in occupational settings, but little is known about the cost-effectiveness of back schools.