Articles: low-back-pain.
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J Manipulative Physiol Ther · Sep 2017
ReviewThe Effectiveness and Safety of Manual Therapy on Pain and Disability in Older Persons With Chronic Low Back Pain: A Systematic Review.
The aim of this study was to perform a systematic review of the literature of the effectiveness and safety of manual therapy interventions on pain and disability in older persons with chronic low back pain (LBP). ⋯ A limited number of studies have investigated the effectiveness and safety of manual therapy in the management of older people with chronic LBP. The current evidence to make firm clinical recommendations is limited. Research with appropriately designed trials to investigate the effectiveness and safety of manual therapy interventions in older persons with chronic LBP is required.
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Observational Study
Fluoroscopy-Guided Sacroiliac Intraarticular Injection via the Middle Portion of the Joint.
Sacroiliac intraarticular injection is necessary to confirm sacroiliac joint (SIJ) pain and is usually performed via the caudal one-third portion of the joint. However, this is occasionally impossible for anatomical reasons, and the success rate is low in clinical settings. We describe a technique via the middle portion of the joint. ⋯ The injection technique via the middle portion of the joint can overcome some of the difficulties of the conventional injection method and can improve the chances of successful intraarticular injection.
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Observational Study
Factors Associated with Successful Responses to Transforaminal Balloon Adhesiolysis for Chronic Lumbar Foraminal Stenosis: Retrospective Study.
Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. ⋯ These results suggest that transforaminal balloon adhesiolysis can successfully lead to improvement of symptoms in patients with chronic lumbar foraminal stenosis caused primarily by degenerative disc herniation.Institutional Review Board (IRB) approval number: 2016-0228.Key words: Balloon, epidural adhesiolysis, chronic pain, radicular pain, lumbar spine, foraminal stenosis, degenerative disc.
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A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. ⋯ This study demonstrates that accurate diagnosis of SIF may be delayed because of difficulties in detecting this type of fracture on plain X-ray and the non-specific nature of the presenting complaints. Emergency physicians should keep SIF in mind when investigating patients who complain of low back pain or gluteal pain. Findings at the second sacral segment on MRI targeting the lumbar spine may aid early diagnosis of this type of pelvic fracture.
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Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Multiple interventional therapies have been developed to treat discogenic pain, but most have not yet been validated by high quality studies.The best studied treatment for discogenic pain is the use of heat, which has been labeled as thermal intradiscal procedures (TIPs) by the Centers for Medicare and Medicaid Services (CMS). As the pathology is located in the annulus, we use the term thermal annular procedures (TAPs). ⋯ The evidence is Level I, or strong, that percutaneous biacuplasty is efficacious in the treatment of chronic, refractory discogenic pain. Biacuplasty may be considered as a first-line treatment for chronic, refractory discogenic pain.The evidence is Level III, or moderate, that IDET is efficacious in the treatment of chronic, refractory discogenic pain.The evidence is Level V, or limited, that discTRODE is efficacious in the treatment of chronic, refractory discogenic pain.Key words: Spinal pain, chronic low back pain, intradiscal disorder, IDET, biacuplasty, discTRODE, thermal intradiscal disorders, thermal annular disorders.