Articles: low-back-pain.
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Randomized Controlled Trial
An implantable restorative-neurostimulator for refractory mechanical chronic low back pain: a randomized sham-controlled clinical trial.
Chronic low back pain can be caused by impaired control and degeneration of the multifidus muscles and consequent functional instability of the lumbar spine. Available treatment options have limited effectiveness and prognosis is unfavorable. We conducted an international randomized, double-blind, sham-controlled trial at 26 multidisciplinary centers to determine safety and efficacy of an implantable, restorative neurostimulator designed to restore multifidus neuromuscular control and facilitate relief of symptoms (clinicaltrials.gov identifier: NCT02577354). ⋯ Prespecified secondary outcomes and analyses were consistent with a modest but clinically meaningful treatment benefit at 120 days. Improvements from baseline, which continued to accrue in all outcome measures after conclusion of the double-blind phase, were clinically important at 1 year. The incidence of serious procedure- or device-related adverse events (3.9%) compared favorably with other neuromodulation therapies for chronic pain.
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Randomized Controlled Trial
Battlefield Acupuncture Versus Standard Pharmacologic Treatment of Low Back Pain in the Emergency Department: A Randomized Controlled Trial.
Battlefield acupuncture (BFA) offers a novel analgesic option that avoids the need for pharmacologic interventions with problematic side effect profiles. ⋯ BFA shows promise for further study as an alternative to standard pharmacologic interventions among adults presenting to the ED with low back pain. © 2021 Elsevier Inc.
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To translate and cross-culturally adapt the Turkish version of the Graded Chronic Pain Scale-Revised (GCPS-R) and to evaluate its reliability and validity. ⋯ The Turkish version of GCPS-R is a valid and reliable questionnaire in patients with chronic low back pain. Level of Evidence II (Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding).
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No reference material exists on the scope of long-term problems in novel spinal pain opioid users. In this study, we evaluate the prevalence and long-term use of prescribed opioids in patients of the Spinal Pain Opioid Cohort. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). ⋯ We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.