Articles: low-back-pain.
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Coccydynia is a disorder that decreases quality of life with significant functional failure. Extra-corporeal shock wave therapy (ESWT) is used to treat several painful musculoskeletal disorders. ⋯ In our patient group, ESWT provided effective pain control. In order to evaluate the efficacy of ESWT more accurately and sensitively, prospective randomized studies with longer follow-up periods, in which ESWT is compared with different energy doses and different treatment methods, are needed.
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The morbidity and mortality associated with opioid and benzodiazepine co-prescription is a pressing national concern. Little is known about patterns of opioid and benzodiazepine use in patients with acute low back pain or lower extremity pain. ⋯ Overall opioid prescribing for low back pain or lower extremity pain decreased substantially during the study period, indicating a shift in management within the medical community. Rates of benzodiazepine prescribing, however, remained at approximately 11%. Concurrent prescriptions of benzodiazepines and opioids after LBP or LEP diagnosis were associated with increased risk of long-term opioid use.
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Along with quantitative measures, pain symptoms may help inform early interventions to prevent prolonged standing induced low back pain (LBP); however, the relationship between quantitative and qualitative measures has not been assessed. ⋯ A subset of participants who were not categorized as LBP developers during prolonged standing using the VAS method still report LBP symptoms. The inclusion of pain symptom reporting could provide additional information for practitioners when identifying individuals who would benefit from early interventions for standing induced LBP.
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Observational Study
SBRS "Surgical Back Risk Syndrome" and Spinal Cord Stimulation: It's better safe than sorry.
Recurrent and chronic low back pain, caused by degenerative lumbar spondylosis, commonly affects elderly patients, even those with no previous low back surgery. These patients, like those affected by failed back surgery syndrome (FBSS), may become unresponsive to medical conservative treatment and their quality of life could be easily compromised. Moreover, general comorbidities, obesity, and other typical conditions of the elderly may make surgery under general anesthesia riskier than the natural history of the disease. These patients could be considered affected by surgical back risk syndrome (SBRS). ⋯ In our opinion, SCS could be considered as a valid alternative treatment not only in selected patients affected by FBSS but also in selected patients affected by SBRS, in whom back surgery under general anesthesia may be challenging and overcome the potential benefit of the surgery itself. SBRS could be considered a new disease entity to be managed through SCS.
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The purpose of this study was to examine the relationships between intervertebral disc degeneration in the lumbar spine, paraspinal muscle morphology, and clinical features in patients with lumbar spinal stenosis (LSS). ⋯ These results suggest that there is some correlation between atrophy of the multifidus and pain intensity. Consequently, focusing on the CSA of the multifidus muscle may help to clarify the causes of LBP in patients with LSS. However, because of the cross-sectional nature of this study, causal relationships could not be determined and further research is needed.