Articles: low-back-pain.
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This study assessed the prevalence rates of psychopathology in acute carpal tunnel syndrome (CTS) and acute low back pain (LBP) patients. Psychopathology was assessed with the Structured Clinical Interview for the DSM-III-R (SCID). ⋯ In regard to other types of psychopathology, such as depression, current substance abuse, and somatoform pain disorders, CTS patients had similar rates as the LBP patients. It was concluded that anxiety disorders may be a concomitant of carpal tunnel syndrome, and that treating psychological problems along with physical aspects of the syndrome may increase the patient's chance of a successful therapeutic outcome.
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Patient selection for repeated spinal surgery is not uniform and must be further refined. A multidisciplinary approach with careful evaluation of physical, psychological and environmental factors is ideal. Improved imaging should delineate disorders more clearly, and advances in surgical technique may improve outcome. It is likely, however, that a number of patients will continue to require long-term pain management.
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J Orthop Sports Phys Ther · Dec 1994
Randomized Controlled Trial Clinical TrialA randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy.
The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: 1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; 2) to track the length of CLBP relief; and 3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34-51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. ⋯ Results revealed that: 1) only low-tech and high-tech exercise produced significant improvements (p < .05) in CLBP, 2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and 3) low-tech exercise was most cost-effective. It was concluded that: 1) low-tech and high-tech exercise were the only effective treatments for CLBP, 2) low-tech exercise produced the longest period of CLBP relief, and 3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.
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The reactivity of surface paraspinal EMG was contrasted among groups of (1) patients seeking treatment for chronic back pain, (2) nonpatients reporting chronic back pain, and (3) healthy controls. The EMG response to the personally relevant stressor (all stimuli were 1 min.) tasks was greater for the patient group relative to the other two groups. However, the patients' magnitude of response elicited by the control task was nearly equal to that of the personally relevant task, suggesting that the task demand to "describe a recent event" may be the "personally relevant" stressor component rather than the emotional valence attached to the content of that description.
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Case Reports
Follicular carcinoma of thyroid presenting as back pain leading to a delay in diagnosis.
The case is described of a 53-year-old man presenting with right-sided low back and thigh pain. Non-urgent investigations showed a metastatic lesion in his right hemipelvis arising from a thyroid primary.