Articles: low-back-pain.
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Ann Acad Med Singap · Jan 1998
Case ReportsMusculoskeletal pain clinic in Singapore--sacroiliac joint somatic dysfunction as cause of buttock pain.
Buttock pain was a predominant symptom in a series of patients seen with recalcitrant "backache" in the author's pain clinic which has a musculoskeletal emphasis. Assessment suggested the sacroiliac joint as the culprit pain generator and patients underwent confirmatory testing which included fluoroscopy-guided intra-articular injections of lignocaine and steroid along with combined therapeutic modalities of oral analgesics, physical therapy, manual medicine techniques and ergonomic assessments. Two case reports illustrate this condition which is probably under-recognised and inadequately addressed locally.
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Randomized Controlled Trial Clinical Trial
Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis.
A randomized, controlled trial, test--retest design, with a 3-, 6-, and 30-month postal questionnaire follow-up. ⋯ A "specific exercise" treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of traction for nonspecific low back pain. 12-week and 6-month results of a randomized clinical trial.
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Studies attempting to correlate facet blocking with successful relief of pain after fusion have reached unfavorable results. These studies, however, did so in a retrospective fashion, and facet blocking was not the sole criterion by which surgical candidates were chosen. The current study is the first to use facet blocking in a prospective fashion and as the definitive criterion by which patients were chosen. ⋯ Nineteen of 23 described 90% relief, 3 patients had 50-90% partial relief, and 1 failed by self-assessment. A preoperative mean Prolo score of 3.95 (range 2-7) improved to 7.7 (range 3-10) with fusion. Provocative facet blocking can be used to successfully predict outcome in patients undergoing arthrodesis for chronic low back pain.
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The purpose of this study was to determine the distribution of referred pain from the lumbar zygapophyseal joints (L1/2 to L5/S1) and the medial branches of the lumbar dorsal rami (Th12 to L5) in a large number of patients with chronic low back pain. ⋯ A total of 71 joints and 91 medial branches were studied in 48 patients. The distribution of referred pain from the L1/2 to L5/S1 zygapophyseal joints, and the medial branches of the dorsal rami from L1 to L5 were similar for each level stimulated, and the overlap of referred pain between each level was considerable.