Articles: low-back-pain.
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Randomized Controlled Trial
Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study.
Low back pain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused by TrPs. ⋯ In this small randomized study with several methodological limitations, TPI was superior to the intravenous NSAIDs in the treatment of acute LBP due to TrPs. TPI can be used in the emergency departments for the acute treatment of LBP in selected patients.
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J Altern Complement Med · Sep 2019
Randomized Controlled Trial Comparative StudyEffectiveness of Hatha Yoga Versus Conventional Therapeutic Exercises for Chronic Nonspecific Low-Back Pain.
Objective: To determine whether the effectiveness of Hatha yoga therapy is comparable to conventional therapeutic exercises (CTEs) for reducing back pain intensity and back-related dysfunction in patients with chronic nonspecific low-back pain (CNLBP). Design: The study was a prospective randomized comparative trial, divided into two phases: an initial 6-weekly supervised intervention period followed by a 6-week follow-up period. Settings: This study was conducted at Department of Physical Medicine and Rehabilitation and Centre for Integrative Medicine and Research of a tertiary care hospital. Subjects: Patients between 18 and 55 years of age with complaint of CNLBP persisting ≥12 weeks with pain rating ≥4 on a numerical rating scale (0-10). Intervention: A total of six standardized 35-min weekly Hatha yoga sessions (yoga group) and similarly 35-min weekly sessions of CTEs (CTE group), designed for people with CNLBP unaccustomed to structured yoga or CTE program. Participants were asked to practice on nonclass days at home. Outcome measures: The primary outcome measures were Defense and Veterans Pain Rating Scale (DVPRS) (0-10) and 24-point Roland Morris Disability Questionnaire (RDQ). Secondary outcomes were pain medication usage per week and a postintervention Perceived recovery (Likert seven-point scale) of back-related dysfunction. ⋯ Both yoga and the CTE group have shown significant improvement in back pain intensity and back-related dysfunction within both the groups at 6- and 12-week follow-ups compared to baseline. No statistically significant differences in the pain intensity (DVPRS; at 6 weeks: n = 35, difference of medians 1.0, 95% confidence interval [-5.3 to 3.0], p = 0.5; at 12 weeks: n = 35, 0.0 [-4.2 to 5.0], 0.7) and back-related dysfunction (RDQ; at 6 weeks: n = 35, 1.0 [-9.6 to 10.6], 0.4; at 12 weeks: n = 35, 0.0 [-8.8 to 10.6], 0.3) were noted between two groups. Improvements in pill consumption and perceived recovery were also comparable between the groups. Conclusion: Yoga provided similar improvement compared with CTEs, in patients with CNLBP.
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Clinical rehabilitation · Sep 2019
Randomized Controlled TrialEffects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial.
To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. ⋯ The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.
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Randomized Controlled Trial Clinical Trial
Cognitive functional therapy in patients with non-specific chronic low back pain-a randomized controlled trial 3-year follow-up.
This randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT-EX) for people with non-specific chronic low back pain (NSCLBP) at 3-year follow-up. ⋯ Cognitive functional therapy (CFT) was more effective than manual therapy and exercise (MT-EX) in reducing disability at 3-year follow-up, in people with non-specific chronic low back pain. The sustained reduction in disability without concomitant reductions in pain intensity in the CFT group suggests a de-coupling of the pain-disability relationship. CFT resulted in long-lasting reductions in anxiety and depression, and pain-related fear regarding work compared to MT-EX. The findings support the long-term benefits of a individualized behaviourally orientated intervention that targets pain beliefs, functional restoration and lifestyle factors.
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Randomized Controlled Trial
Assessment of potentially abuse-related events in two phase 3 studies of NKTR-181, a novel opioid analgesic, using the MADDERS® system (Misuse, Abuse, and Diversion Drug Event Reporting System).
Objective: To prospectively evaluate the abuse potential of NKTR-181, a novel opioid analgesic, in two phase 3 clinical trials using a newly developed reporting system: the Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS®). Methods: SUMMIT-07 was an enriched enrollment randomized withdrawal study that examined the safety and efficacy of NKTR-181 across 12 weeks in opioid-naïve subjects with chronic low back pain. SUMMIT-LTS was a 52 week open-label study in opioid-naïve and experienced subjects with chronic low back pain or noncancer pain rolled over from SUMMIT-07 or enrolled de novo. ⋯ Most events were attributed to "Withdrawal" and, primarily in SUMMIT-07, "Therapeutic Error" (unintentional overuse) or "Misuse" (intentional overuse for a therapeutic purpose) of study medication. Adjudicators identified five possible "Abuse" events (three NKTR-181, two placebo) in SUMMIT-07 and four possible "Abuse" events (all NKTR-181) in SUMMIT-LTS. Conclusions: The MADDERS® system discerns potentially abuse-related events and identified low rates of withdrawal and a low risk of abuse potential, diversion or addiction associated with NKTR-181 in phase 3 trials.