Articles: low-back-pain.
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A prospective study of patients treated with a light mobilization program for long-term low back pain. ⋯ The final discriminant function may have potential as a brief screening instrument for the number of patients with low back pain who do not benefit from the light mobilization program.
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Randomized Controlled Trial Clinical Trial
A placebo-controlled randomized clinical trial of nortriptyline for chronic low back pain.
To assess the efficacy of nortriptyline, a tricyclic antidepressant, as an analgesic in chronic back pain without depression, we conducted a randomized, double-blind, placebo-controlled, 8-week trial in 78 men recruited from primary care and general orthopedic settings, who had chronic low back pain (pain at T-6 or below on a daily basis for 6 months or longer). Of these 57 completed the trial; of the 21 who did not complete, four were withdrawn because of adverse effects. The intervention consisted of inert placebo or nortriptyline titrated to within the therapeutic range for treating major depression (50-150 ng/ml). ⋯ Also, completers with radicular pain on nortriptyline (n = 5) had significantly (P < 0.05) better analgesia and overall outcome than did those on placebo (n = 6). The results suggest noradrenergic mechanisms are relevant to analgesia in back pain. This modest reduction in pain intensity suggests that physicians should carefully weigh the risks and benefits of nortriptyline in chronic back pain without depression.
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Comparative Study
Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation.
The correlation between discogenic lumbar pain and disc morphology was investigated by using magnetic resonance imaging and discography. ⋯ Although the lumbar intervertebral discs with posterior combined anular tears are likely to produce pain, the validity of these signs for predicting discogenic lumbar pain is limited.
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Comparative Study
Comparison of bone single-photon emission tomography and planar imaging in the detection of vertebral metastases in patients with back pain.
Bone scan has long been considered to be an important diagnostic test in searching for bone metastases. However, considerable difficulty is encountered in the vertebral region due to the complexity of structures and the fact that other benign lesions, especially degenerative changes, are very common there. Single-photon emission tomography (SPET) has been reported to be useful in the differentiation of benign from malignant conditions. ⋯ Except with regard to the negative predictive value, SPET performed statistically better than planar imaging. Only 9/147 (6.4%) lesions involving the vertebral body alone and 3/49 (6.1%) lesions involving facet joints alone were subsequently found to be metastases. We conclude that bone SPET is an accurate diagnostic test for the detection of vertebral metastases and is superior to planar imaging in this respect.
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Data Strateg Benchmarks · Jun 1998
Comparative StudyRegional data on low back pain point to improvement potential.
Data Library: Benchmark your organization's treatment of low back pain. There's wide variation in specialty provider use, utilization of services, and costs of this high-volume medical problem--despite federal guidelines stipulating treatment recommendations. These data are broken out by specialty and on a regional basis.