Articles: low-back-pain.
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The purposes of this study were to explore the coping strategies used by patients with chronic low back pain, to test hypothesized mediators of the relationship between self-efficacy and pain outcomes, and to determine the roles of self-efficacy and outcome expectancies in coping with pain in patients (N = 85) with chronic low back pain. The most common coping behaviors were reporting pain, using pain medications, and coping self-statements. Patients' self-efficacy to cope with pain was inversely correlated with pain intensity. ⋯ Perseverance of coping effort was found to mediate the effects of self-efficacy on pain outcomes; however, level of distress was not found to be a mediator. Outcome expectancies were positively correlated with perseverance of coping effort. These findings are discussed in terms of implications for practice and directions for future research.
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The association between subjective experience in pain reduction and objective measurements in improvement of physical functioning was analyzed with chronic low back pain (CLBP) patients (n = 143) who attended a 12-week multidimensional back treatment program emphasizing active functional restoration. Low back flexion-extension, lateral flexion and rotation, isometric strength, and mobility and their changes were measured. The results showed that 79% of the subjects reported subjective decrease in LBP during the 12-week restoration program, and simultaneous increases in isometric strength and mobility also were measured in approximately 80% of the subjects. ⋯ Thus, absolute levels at the baseline or magnitude of changes in the measurements of maximum isometric strength or mobility were not associated with pain reduction. The results indicate that subjective pain reduction is significantly associated with improvement per se in trunk muscle function and spinal mobility during active functional restoration, but not with the magnitude of the improvements. This should be considered when designing rehabilitation programs and outcome criteria for rehabilitation.
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J Bone Joint Surg Br · Jul 1996
The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration.
The afferent pathways of discogenic low-back pain have not been fully investigated. We hypothesised that this pain was transmitted mainly by sympathetic afferent fibres in the L2 nerve root, and in 33 patients we used selective local anaesthesia of this nerve. Low-back pain disappeared or significantly decreased in all patients after the injection. ⋯ Our findings show that the main afferent pathways of pain from the lower intervertebral discs are through the L2 spinal nerve root, presumably via sympathetic afferents from the sinuvertebral nerves. Discogenic low-back pain should be regarded as a visceral pain in respect of its neural pathways. Infiltration of the L2 nerve is a useful diagnostic test and also has some therapeutic value.
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Data were obtained in a Danish cross-sectional postal survey and compared with information from four methodologically similar studies conducted in some of the Nordic countries between 1977-1985. ⋯ When data were examined from five methodologically similar studies on the 30- to 50-year-old Nordic population, there was reasonable consistency of prevalence figures. Thus, approximately 66% report having had low back pain at least sometime during their lifetime and approximately 50% sometime during the preceding year, with no significant differences relating to age or sex. The best method to investigate whether low back pain is on the increase might be through replicate studies.
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J Epidemiol Community Health · Jun 1996
Prevalence of low back pain in the community: implications for service provision in Bradford, UK.
To assist a purchasing district in the planning of services for low back pain by assessing the prevalence of symptoms and the current involvement of primary, secondary, and complementary care in the treatment of low back pain. In the light of these findings, to assess further the potential impact of a new system of open access to physical therapy, as recommended by the British Clinical Standards Advisory Group (CSAG). ⋯ Local prevalence estimates may allow purchasers to estimate the potential effects of a shift in management policy for low back pain and to highlight areas of unmet need in terms of resources and patient education.