Articles: low-back-pain.
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"Pain under Discussion" aims at the education of patients with chronic headache and back pain by applying a standardized manual with detailed instructions for seven sessions in a group setting. Apart from encouraging a reconceptualization of the patients' pain experience with reference to a bio-psycho-social model, the program provides information about the vicious circle of pain, avoidance and demoralization and relies heavily on behavioral assumptions about the process of chronicity. Patients are offered participation in progressive relaxation according to Jacobson, they learn to engage in pleasant activities, and are instructed to more and more maintain an upright body position during various activities of every day life. The study evaluates the outcome of the training. Moreover, as an algorithm for grading pain patients according to their level of chronicity has recently been developed by Gerbershagen, we use this algorithm in order to investigate the relationship between the outcome of treatment and the assigned level of chronicity. In addition, we test the assumption that a higher level of chronicity is related to a lower level of psychological functioning pre treatment. ⋯ Irrespective of the initial pain grading of the patients the training program has proven to be effective with regard to different outcome measures.
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One hundred eight patients from a consecutive series of 125 anterior lumbar interbody fusions were invited to take part in a clinical outcome assessment (including plain radiography and magnetic resonance imaging of the lumbosacral spine) more than 10 years after the original surgery. ⋯ The findings of the study suggest that the assessment of outcome of lumbar interbody fusion is strongly compounded by the psychological make-up of the patient and that this effect is maintained in the long term. However, the negative effect of compensation observed at 2 years seems to dissipate with time and becomes insignificant at 10 years.
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This investigation had two components: one was an item analysis that examined data obtained at the initial patient assessment, and the second was a validation study that used a pretest-posttest design. ⋯ The RM-18 can be used as an outcome measure in clinical trials or as a tool to aid in decision making concerning individual patients. In either case, its measurement properties are equal to those of the 24-item Roland-Morris Questionnaire.
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The authors investigated the innervation of discographically confirmed degenerated and "painful" human intervertebral discs. ⋯ Findings indicate a more extensive disc innervation in the severely degenerated human lumbar disc compared with normal discs. The nociceptive properties of at least some of these nerves are highly suggested by their substance P immunoreactivity, which provides further evidence for the existence of a morphologic substrate of discogenic pain.
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Acta Obstet Gynecol Scand · Oct 1997
Review Randomized Controlled Trial Comparative Study Clinical TrialOral contraceptive use among female elite athletes and age-matched controls and its relation to low back pain.
Exogenous and endogenous female sex steroids may influence the risk of low back pain. The fact that back pain is a very common symptom during pregnancy supports this theory. Back pain is also more common among female than male athletes. Oral contraceptives have been suggested to increase the risk of low back pain. ⋯ This study does not support the theory that low back pain is affected by the use of oral contraceptives. Instead, constitutional factors and mechanical stress during intense physical activity is probably more important.