Articles: low-back-pain.
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Randomized Controlled Trial
Effects of focusing and distraction on cold pressor-induced pain in chronic back pain patients and control subjects.
Previous studies showed equivocal findings regarding the efficacy of focused attention and distraction to experimental pain. This study examined the relative efficacy of these strategies on perception of cold pressor pain in 41 chronic back pain patients and 41 healthy control participants. Participants were randomized to the 2 strategies and then completed a 7-minute cold pressor test. Pain intensity and discomfort ratings were obtained during the task. Participants who completed the first task were asked to complete a second cold pressor task without instructions. Pain and discomfort ratings differed by condition across time. In the distraction condition, pain levels started low but continued to rise throughout the cold pressor immersion, whereas in the focused attention condition, pain levels started higher, rose less quickly, and then decreased from the middle of the task. Focused attention was associated with higher pain and lower completion rates in chronic pain patients compared with healthy control subjects. Focused attention might therefore not be an effective intervention strategy for individuals with chronic back pain. Finally, in the second cold pressor test, patients' pain reports rose more rapidly than those of healthy control subjects. The results of this study can be explained in terms of differences in cognitive appraisal between pain patients and healthy control participants. ⋯ Marked differences were found between chronic back pain patients and control participants regarding focused attention as compared with distraction as a means of coping with cold pressor-induced pain. These differences underline the importance of taking into account previous experience with pain when recommending strategies to cope with painful procedures.
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Randomized Controlled Trial
[Therapeutic ultrasound in chronic low back pain treatment].
The purpose was to determine the efficacy of therapeutic ultrasound in patients with chronic low back pain. Thirty-one patients, age 38-77, with low back pain lasting more than three months and the intensity of pain on visual analogue scale at least 50 mm, are randomly divided in two groups. Ultrasound is applied on the lumbar paravertebral muscle in 16 patients and in 15 patients the machine was not switched on. ⋯ The value of the modified Schober measure for the ultrasound group were 5,7+0,8 cm vs. 5,8+/-0,9 cm (p>0,05) and in the placebo group were 5,4+/-0,9 cm vs. 5,6+/-1,0 cm (p>0,05). There was no significant statistical difference between ultrasound and placebo group regarding the efficacy of the treatment (patients p>0,05, physicians p>0,05). Therapeutic ultrasound was effective in decreasing the pain intensity in this research, but showed no improvement regarding the functional ability of the lumbar spine in patients with chronic low back pain.
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Randomized Controlled Trial Comparative Study
The effect of sedation on diagnostic validity of facet joint nerve blocks: an evaluation to assess similarities in population with involvement in cervical and lumbar regions (ISRCTNo: 76376497).
Zygapophysial or facet joint pain in patients suffering with chronic spinal pain without disc herniation or radiculopathy may be diagnosed with certainty by the use of controlled diagnostic blocks. But, in patients suffering with either lumbar or cervical facet joint pain, even this diagnostic approach may be confounded by false-positives when using a single diagnostic block. It may also be confounded by the administration of anxiolytics and narcotics prior to, or during, the controlled diagnostic facet joint blocks. The effect of sedation on the validity and potential differential results in patients suffering with combined cervical and lumbar facet joint pain has not been evaluated. ⋯ Perioperative administration of sodium chloride, midazolam, or fentanyl can confound results in the diagnosis of combined cervical and lumbar facet joint pain. False-positive results with placebo or sedation may be seen in a small proportion of patients.
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Randomized Controlled Trial Multicenter Study
Analgesic efficacy and safety of lornoxicam quick-release formulation compared with diclofenac potassium: randomised, double-blind trial in acute low back pain.
NSAIDs are widely used for patients presenting with low back pain. A quick-release formulation of lornoxicam, a potent NSAID from the chemical class of oxicams, offers a faster onset of pain relief compared with the standard tablet formulation. ⋯ Lornoxicam administered as a quick-release formulation was shown to be non-inferior to the equivalent formulation of diclofenac potassium in terms of onset of pain relief and more effective on most of the major standard efficacy outcomes.
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Randomized Controlled Trial
The influence of a Functional Capacity Evaluation on fitness for work certificates in patients with non-specific chronic low back pain.
Comprehensive medical assessments in the majority of patients with chronic low back pain (CLBP) have failed to assess working capacity. Functional Capacity Evaluation (FCE) has become increasingly popular in the evaluation of working capacity in CLBP patients. This study investigates the influence of functional testing on decision making concerning medical fitness assessments for work. ⋯ Functional Capacity Evaluation positively influences quality and information regarding working capacity of medical Fitness for Work Certificates in patients with chronic low back pain.