Articles: low-back-pain.
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Chronic low back pain causes structural remodelling and inflammation in the multifidus muscle. Collagen expression is increased in the multifidus of humans with lumbar disc degeneration. However, the extent and mechanisms underlying the increased fibrotic activity in the multifidus are unknown. Physical activity reduces local inflammation that precedes multifidus fibrosis during intervertebral disc degeneration (IDD), but its effect on amelioration of fibrosis is unknown. This study aimed to assess the development of fibrosis and its underlying genetic network during IDD and the impact of physical activity. ⋯ These data reveal the fibrotic networks that promote fibrosis in the multifidus muscle during chronic IDD. Furthermore, physical activity is shown to reduce fibrosis and regulate the fibrotic gene network. These slides can be retrieved under Electronic Supplementary Material.
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Complement Ther Clin Pract · May 2019
Change in young people's spine pain following chiropractic care at a publicly funded healthcare facility in Canada.
The presence of spinal pain in young people has been established as a risk factor for spinal pain later in life. Recent clinical practice guidelines recommend spinal manipulation (SM), soft tissue therapy, acupuncture, and other modalities that are common treatments provided by chiropractors, as interventions for spine pain. Less is known specifically on the response to chiropractic management in young people with spinal pain. The purpose of this manuscript was to describe the impact, through pain measures, of a pragmatic course of chiropractic management in young people's spinal pain at a publicly funded healthcare facility for a low-income population. ⋯ The findings of the present study provide evidence that a pragmatic course of chiropractic care, including SM, mobilization, soft tissue therapy, acupuncture, and other modalities within the chiropractic scope of practice are a viable conservative pain management treatment option for young people.
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Patients with nonspecific low back pain (NSLBP) rely more on the ankle compared with the lower back proprioception while standing, perform sit-to-stand-to-sit (STSTS) movements slower, and exhibit perceptual impairments at the lower back. However, no studies investigated whether these sensorimotor impairments relate to a reorganization of the primary and secondary somatosensory cortices (S1 and S2) and primary motor cortex (M1) during proprioceptive processing. ⋯ The results suggest that patients with NSLBP show a reorganization of the higher-order processing of lower back proprioception, which could negatively affect spinal control and body perception.
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Imaging (X-ray, CT and MRI) provides no health benefits for low back pain (LBP) patients and is not recommended in clinical practice guidelines. Whether imaging leads to increased costs, healthcare utilization or absence from work is unclear. Therefore, this study systematically reviews if imaging in patients with LBP leads to an increase in these outcomes. ⋯ Imaging in LBP may be associated with higher medical costs, increased healthcare utilization and more absence from work. These slides can be retrieved under Electronic Supplementary Material.