Articles: low-back-pain.
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Vitamins of the B group have long been used to treat neuropathies of different origins and the accompanying pain. A combination of the vitamins B(1), B(6), and B(12) prevents the slowing of impulse conduction produced by tetanic stimulation in diabetic mice. In patients suffering from diabetic neuropathy, B vitamins alleviate pain in the upper extremities. ⋯ It has recently also been reported that a combination of the vitamins B1, B6, and B12 has analgesic properties in non-neuropathic conditions. In animal experiments, B vitamins diminish nociceptive responses in spinal and thalamic neurones and potentiate the antinociceptive effect of analgesic agents. Similarly, B vitamins potentiate the therapeutic effect of diclofenac in patients suffering from acute low back pain.
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Scand J Prim Health Care · Sep 1992
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA controlled, multicentre trial of manual therapy in low-back pain. Initial status, sick-leave and pain score during follow-up.
101 outpatients with acute or subacute low-back pain were randomly allocated to one of two treatment groups. One group was given standardized conventional but optimal activating treatment by primary health care teams. The other group received manual treatment such as manipulation, specific mobilization, muscle stretching, auto-traction, and cortisone injections. ⋯ The difference diminished over time but was still significant after eight months. Two slightly different pain scores ("pain at the moment" and "pain during the last weeks"), initially similar in the two groups, diminished in both groups but were significantly lower in the manual treatment group during the study. The group receiving specific manual treatment thus had a significantly better outcome than the group receiving conventional treatment as far as sick-leave and pain score are concerned.
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Thirty-six subjects participated in an 18-month follow-up of a secondary prevention program for back pain of recent onset. The follow-up assessment included most of the same instruments used in the original study. In addition, interviews were conducted to ascertain help and hindrance factors for maintaining improvements during the follow-up period. ⋯ A cost-benefit analysis indicated substantial economic savings when follow-up sick-listing data were compared with estimates based on an increasing trend for pain-related absenteeism found during the baseline period. Hindrance factors reported by subjects were related to personal time-management and workplace factors, especially psychosocial aspects of the work environment. It was concluded that the secondary prevention program was effective and that future maintenance programs should focus more on personal time-management and workplace factors.
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A patient underwent outpatient knee arthroscopy with spinal anesthesia administered at the patient's request. The patient was discharged after a 3-hour recovery period. Three days later, the patient returned because of a headache that had begun the evening after surgery and progressively worsened. ⋯ Therapy with aspirin 600 mg 4 times daily resulted in acute and significant relief. The backache resolved after 1 week. A review of the literature on backache following epidural blood patch is presented.
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To assess the utilization of diagnostic and therapeutic medical services for the management of acute low back pain in a primary care setting, and to determine whether such utilization conforms to suggested guidelines for the management of this condition. ⋯ According to guidelines from the medical literature, the primary care physicians in this study both overutilized and underutilized diagnostic and referral services in cases of acute low back pain. It is necessary to determine whether underutilization of plain lumbar radiography adversely affects diagnostic accuracy and whether overutilization of other services improves important clinical outcomes, given the generally benign natural history of this condition.