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1. Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain?

Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain? Diagnosis | Diagnosis | Back pain - low (without radiculopathy) | CKS | NICE Search CKS… Menu Diagnosis Back pain - low (without radiculopathy): How should I diagnose the cause of low back pain? Last revised in November 2018 How should I diagnose the cause of low back pain? Assess the person. Ask about the type of pain, duration of symptoms, aggravating and relieving factors, associated symptoms (...) , radiation of pain, night pain. Examine the person. Observe gait, posture, skin and any bruising, skin changes, rashes, deformity or swelling of the back. Perform a neurological examination looking for loss of sensation, changes to reflexes, limitation of range of movement including straight leg raising, tenderness, fever and loss of anal tone. Assess for the presence of that may suggest a serious underlying cause, such as: Cauda equina syndrome. Cancer of the spine. Spinal fracture due to trauma

2018 NICE Clinical Knowledge Summaries

2. Radiofrequency denervation for chronic back pain stemming from the facet joints

Radiofrequency denervation for chronic back pain stemming from the facet joints Radiofrequency denervation for chronic back pain stemming from the facet joints We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Radiofrequency denervation for chronic back pain stemming from the facet joints Share: Reading time approx. 7 minutes Chronic backpain is very (...) common and can often be traced to the facet joints. Facet joints are located between the protruding portions of adjacent vertebrae and serve to guide and stabilise the backbone, especially when extending or twisting. Radiofrequency ablation aims to alleviate back pain by disrupting the transmission of pain signals carried by the spinal nerves associated with the facet joints. Question What systematic reviews have been published that assess the efficacity of radiofrequency denervation in treating

2020 Swedish Council on Technology Assessement

3. Therapeutic ultrasound for chronic low back pain. (Abstract)

Therapeutic ultrasound for chronic low back pain. This is an update of a Cochrane Review published in 2014. Chronic non-specific low back pain (LBP) has become one of the main causes of disability in the adult population around the world. Although therapeutic ultrasound is not recommended in recent clinical guidelines, it is frequently used by physiotherapists in the treatment of chronic LBP.The objective of this review was to determine the effectiveness of therapeutic ultrasound (...) for imprecision) of little to no difference in the number of participants achieving a 30% reduction in pain in the short term (risk ratio 1.08, 95% CI 0.81 to 1.44; n = 225, 1 RCT). There was low-certainty evidence (downgraded for imprecision and limitations in design) that therapeutic ultrasound has a small effect on back-specific function compared with placebo in the short term (standardised mean difference -0.29, 95% CI -0.51 to -0.07 (MD -1.07, 95% CI -1.89 to -0.26; Roland Morris Disability Questionnaire

2020 Cochrane

4. Non-steroidal anti-inflammatory drugs for acute low back pain. (Abstract)

Non-steroidal anti-inflammatory drugs for acute low back pain. Acute low back pain (LBP) is a common health problem. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used in the treatment of LBP, particularly in people with acute LBP. In 2008, a Cochrane Review was published about the efficacy of NSAIDs for LBP (acute, chronic, and sciatica), identifying a small but significant effect in favour of NSAIDs compared to placebo for short-term pain reduction and global improvement (...) ) or alternative treatments for acute LBP in adults (≥ 18 years); conducted in both primary and secondary care settings. We assessed the effects of treatment on pain reduction, disability, global improvement, adverse events, and return to work.Two review authors independently selected trials to be included in this review, evaluated the risk of bias, and extracted the data. If appropriate, we performed a meta-analysis, using a random-effects model throughout, due to expected variability between studies. We

2020 Cochrane

5. In adults with chronic low back pain, are core stability exercises more effective in improving function and decreasing pain compared to a general exercise programme?

In adults with chronic low back pain, are core stability exercises more effective in improving function and decreasing pain compared to a general exercise programme? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: 9/1/2018 CAT Lead: Lucy Thomas Date CAT completed: 9/1/2018 Email: lucy.thomas@sath.nhs.uk Date CAT to be reviewed: January 2021 Review CAT Clinical bottom line In adults with chronic low back pain core stability exercises (...) are not superior to other forms of exercise in improving function and decreasing pain. Clinical practice should aim to promote general exercise. Why is this important? Low back pain is a common condition which is treated in outpatient physiotherapy departments. Current evidence suggests that no single exercise is superior to another. Core stability exercises are among the most commonly used interventions in the treatment of back pain but could the use of a more general approach to exercise be just as effective

2018 Public Health England

6. Transaxial interbody lumbosacral fusion for severe chronic low back pain

Transaxial interbody lumbosacral fusion for severe chronic low back pain T T r ransaxial interbody lumbosacr ansaxial interbody lumbosacral fusion for al fusion for se sev vere chronic low back pain ere chronic low back pain Interventional procedures guidance Published: 25 July 2018 nice.org.uk/guidance/ipg620 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement (...) (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 41 1 Recommendations Recommendations 1.1 Evidence on the safety of transaxial interbody lumbosacral fusion for severe chronic low back pain shows that there are serious but well-recognised complications. Evidence on efficacy is adequate in quality and quantity. Therefore, this procedure may be used provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 This procedure should only

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

7. Discogenic low back pain

Discogenic low back pain Discogenic low back pain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Discogenic low back pain Last reviewed: February 2019 Last updated: January 2019 Summary Magnetic resonance imaging is the imaging study of choice for degenerative disc disease due to its unique detail on the representation of the disc status. Other tests may include plain radiographs, computed tomography scanning (...) , or provocative discography. Non-surgical treatments include lifestyle measures, followed by the judicious use of medications, physiotherapy, and therapeutic needling procedures. Surgical treatment includes decompression of neural structures and, in selected patients, a fusion of the motion segment. Definition A complex, multi-factorial, clinical condition characterised by low back pain with or without the concurrence of radicular lower limb symptoms in the presence of radiologically-confirmed degenerative

2019 BMJ Best Practice

8. Low back pain

Low back pain Evidence Maps - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4

2018 Trip Evidence Maps

9. Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines Background: Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body’s own inherent healing armamentarium in the treatment of patient pathology. This therapy’s intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or allogenic biologics (...) evidence regarding the use of medicinal signaling/ mesenchymal stem cell (MSCs) with a high-quality RCT, multiple moderate-quality observational studies, a single-arm meta-analysis, and 2 systematic reviews, the qualitative evidence has been assessed as Level III (on a scale of Level I through V) using a qualitative modified approach to the grading of evidence based Guidelines Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain

2019 American Society of Interventional Pain Physicians

10. Lateral interbody fusion in the lumbar spine for low back pain

Lateral interbody fusion in the lumbar spine for low back pain Later Lateral interbody fusion in the lumbar spine for al interbody fusion in the lumbar spine for low back pain low back pain Interventional procedures guidance Published: 22 February 2017 nice.org.uk/guidance/ipg574 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals (...) -and- conditions#notice-of-rights). Page 1 of 91 1 Recommendations Recommendations 1.1 Current evidence on the safety of lateral (including extreme, extra and direct lateral) interbody fusion in the lumbar spine for low back pain shows there are serious but well-recognised complications. Evidence on efficacy is adequate in quality and quantity. Therefore, this procedure may be used provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 This procedure should only

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

11. Wearables with Neuroreceptor Activation Patterns for Foot Neuropathy or Musculoskeletal Foot or Back Pain: Clinical Effectiveness

Wearables with Neuroreceptor Activation Patterns for Foot Neuropathy or Musculoskeletal Foot or Back Pain: Clinical Effectiveness Wearables with Neuroreceptor Activation Patterns for Foot Neuropathy or Musculoskeletal Foot or Back Pain: Clinical Effectiveness | CADTH.ca Find the information you need Wearables with Neuroreceptor Activation Patterns for Foot Neuropathy or Musculoskeletal Foot or Back Pain: Clinical Effectiveness Wearables with Neuroreceptor Activation Patterns for Foot Neuropathy (...) or Musculoskeletal Foot or Back Pain: Clinical Effectiveness Last updated: August 27, 2019 Project Number: RA1066-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical effectiveness of wearables incorporating a neuroreceptor activation sequence or pattern for foot neuropathy? What is the clinical effectiveness of wearables incorporating a neuroreceptor activation sequence or pattern for foot pain or back pain of musculoskeletal origin

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

12. Strength-based Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness

Strength-based Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness Strength-based Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Strength-based Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness Strength-based Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness Last updated: September 27, 2019 Project Number: RC1193-000 Product Line: Research (...) Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of strength-based exercise for chronic non-cancer back pain? Key Message No evidence was found regarding the clinical effectiveness of strength-based exercise alone compared with pharmacological interventions for chronic non-cancer back pain in non-pregnant people. Files Rapid Response Summary with Critical Appraisal Published : September 27, 2019 Follow us: © 2019

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

13. When to order MRI for low back pain

When to order MRI for low back pain Globally, low back pain leads to more years lived with disability than any other symptom or condition. 1 The prevalence of low back pain is higher among middle-aged people, as well as in high-income countries, such as Singapore. 2 As low back pain is largely a self-limiting condition, imaging is not indicated in most cases. When indicated, magnetic resonance imaging (MRI) of the lumbar spine is one of several imaging modalities for low back pain. However, its (...) clinical utility varies with the clinical presentation and working diagnosis. When to order MRI for low back pain Target audience This clinical guidance is relevant to all healthcare professionals ordering MRI of the lumbar spine Objective To enhance appropriate use of magnetic resonance imaging (MRI) Scope MRI of the lumbar spine for diagnostic investigation of low back pain Published: 1 October 2020 www.ace-hta.gov.sg ACE CLINICAL GUIDANCE Statement of Intent This ACE Clinical Guidance (ACG) provides

2020 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

14. A study of healthcare utilization in patients with chronic low back pain using Alberta’s administrative health data

A study of healthcare utilization in patients with chronic low back pain using Alberta’s administrative health data application/octet-stream

2020 Institute of Health Economics

15. Diagnosis and Treatment of Low Back Pain

Diagnosis and Treatment of Low Back Pain Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain 7075 Veterans Blvd Burr Ridge, IL 60527 630-230-3600 www.spine.org © 2020 North American Spine Society 978-1-929988-65-5Diagnosis & Treatment of Low Back Pain | Preface Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting literature which excluded conditions such as presence (...) of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low back pain in its entirety. This clinical guideline is not intended to be a fixed treatment protocol; it is anticipated that there will be patients who require more or less treatment than what is outlined. This clinical guideline should not be construed as including all proper methods of care or excluding other

2020 North American Spine Society

16. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain

Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain 7075 Veterans Blvd Burr Ridge, IL 60527 630-230-3600 www.spine.org © 2020 North American Spine Society 978-1-929988-65-5Diagnosis & Treatment of Low Back Pain | Preface Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting (...) literature which excluded conditions such as presence of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low back pain in its entirety. This clinical guideline is not intended to be a fixed treatment protocol; it is anticipated that there will be patients who require more or less treatment than what is outlined. This clinical guideline should not be construed

2020 American Academy of Pain Medicine

17. Quebec Back Pain Disability Scale for Low Back Pain: Accuracy and Reliability

Quebec Back Pain Disability Scale for Low Back Pain: Accuracy and Reliability Quebec Back Pain Disability Scale for Low Back Pain: Accuracy and Reliability | CADTH.ca Find the information you need Quebec Back Pain Disability Scale for Low Back Pain: Accuracy and Reliability Quebec Back Pain Disability Scale for Low Back Pain: Accuracy and Reliability Published on: July 14, 2015 Project Number: RB0886-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result (...) type: Report Question What is the accuracy and reliability of the Quebec Back Pain Disability Scale for low back pain? Key Message Two non-randomized studies were identified regarding accuracy and reliability of the Quebec Back Pain Disability Scale for low back pain. Tags back ache, back pain, backache, disability evaluation, low back pain, lower back pain, pain measurement, quebec, questionnaires, rehabilitation, sensitivity and specificity, musculoskeletal, QBPDS, Quebec Back Pain Disability

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

18. Musculoskeletal lower back pain

Musculoskeletal lower back pain Musculoskeletal lower back pain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Musculoskeletal lower back pain Last reviewed: February 2019 Last updated: October 2018 Summary Diagnosis is made by eliminating specific lower back pain causes of neurological compromise, neoplasia, inflammatory arthritis, fracture, or referred pain from other locations or organ systems. Pain, stiffness (...) to support this are inconclusive. Definition Musculoskeletal lower back pain is pain, stiffness, and/or soreness of the lumbosacral region (underneath the twelfth rib and above the gluteal folds). Lower back pain is subdivided by time frame into acute lower back pain lasting <4 weeks, subacute lower back pain lasting 4 to 12 weeks, and chronic lower back pain lasting >12 weeks. An exclusion diagnosis is made by eliminating specific causes of lower back pain arising from neurological compromise, neoplasia

2018 BMJ Best Practice

19. Discogenic low back pain

Discogenic low back pain Discogenic low back pain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Discogenic low back pain Last reviewed: February 2019 Last updated: January 2019 Summary Magnetic resonance imaging is the imaging study of choice for degenerative disc disease due to its unique detail on the representation of the disc status. Other tests may include plain radiographs, computed tomography scanning (...) , or provocative discography. Non-surgical treatments include lifestyle measures, followed by the judicious use of medications, physiotherapy, and therapeutic needling procedures. Surgical treatment includes decompression of neural structures and, in selected patients, a fusion of the motion segment. Definition A complex, multi-factorial, clinical condition characterised by low back pain with or without the concurrence of radicular lower limb symptoms in the presence of radiologically-confirmed degenerative

2018 BMJ Best Practice

20. Assessment of back pain

Assessment of back pain Assessment of back pain - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of back pain Last reviewed: February 2019 Last updated: September 2018 Summary Back pain is the primary cause of disability in people <50 years of age. The annual incidence in the adult population is 10% to 15% with a point prevalence of approximately 30% in developed countries. Low-back pain (LBP) is second (...) . 1991 Jan;16(1):1-6. http://www.ncbi.nlm.nih.gov/pubmed/1825891?tool=bestpractice.com Burton AK, Tillotson KM, Main CJ, et al. Psychosocial predictors of outcome in acute and subacute low back trouble. Spine. 1995 Mar 15;20(6):722-8. http://www.ncbi.nlm.nih.gov/pubmed/7604349?tool=bestpractice.com Carragee EJ, Alamin TF, Miller JL, et al. Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Spine

2018 BMJ Best Practice

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