Articles: low-back-pain.
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This study evaluated the incidence of lumbar isthmic spondylolisthesis among subjects permanently disabled because of low back pain syndromes. ⋯ The finding that the incidence corresponds well with the incidence in the normal population may suggest that lumbar isthmic spondylolisthesis does not invariably lead to severe impairment or disability, although location of the defect at the level proximal to L5 may be connected to an increased risk for permanent low back disability.
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Studies indicate that work disabled chronic back pain patients out of work for longer than three months have a reduced probability of returning to work. The escalating personal and economic costs (indemnity and health care) associated with such long term disability have facilitated efforts at multiple levels to prevent and more effectively manage work disability. Multidisciplinary rehabilitation (MDR) targeted at return to work represents one such approach. ⋯ Research on predictors of return to work outcome following MDR were identified and included variables in five categories: demographics, medical history, physical findings, pain and psychological characteristics. The literature provides support for the use of integrated approaches that target the medical, physical, ergonomic and psychosocial factors that can exacerbate and/or maintain work disability. Future research should address current methodological limitations in the literature and focus on: 1) identifying critical treatment components of such approaches, 2) developing innovative screening methods to identify high risk cases to facilitate earlier more targeted efforts to assist such individuals, and 3) consider variations in the staging of various combinations of interventions in an effort to develop more cost-effective variations in the multidisciplinary approach.
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To determine the relationship between pain provocation and the analgesic response in lumbar zygapophyseal joint blocks. ⋯ This study calls into question the validity of pain provocation alone as a criterion standard in patients undergoing diagnostic lumbar zygapophyseal joint blocks.
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The aim of this study was to assess the ability of specific and clinically relevant Minnesota Multiphasic Personality Inventory (MMPI) profile types to predict outcomes in a structured interdisciplinary pain-management program for patients with low back pain. ⋯ Even when subjects with chronic pain are divided into cluster groups associated with highly similar clinical interpretations, the MMPI for the most part fails to predict self-reported outcomes in an interdisciplinary pain-management program.
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A 21-year-old man suffered from diffuse low back pain and sciatica for 10-s periods once or twice a day over a period of 6 months. After this, pain became chronic and was resistant to conventional conservative treatment. Only acetylsalicylic acid diminished pain. ⋯ The time between onset of symptoms and final diagnosis was 18 months. Symptoms disappeared after surgery. Clinical and radiological aspects of the case are discussed.