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Latest & greatest articles for low back pain
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Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. OBJECTIVE: To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Physiotherapy Evidence (...) Database (PEDro), Index to Chiropractic Literature, and trial registries up to 4 May 2018, including reference lists of eligible trials and related reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of spinal manipulation or mobilisation in adults (≥18 years) with chronic low back pain with or without referred pain. Studies that exclusively examined sciatica were excluded, as was grey literature. No restrictions were applied to language or setting
Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines 30717500 2019 02 05 2150-1149 22 1S 2019 Jan Pain physician Pain Physician Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. S1-S74 Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own (...) . Appropriate precautions should be taken into consideration and followed prior to performing biologic therapy. Multiple guidelines from the Food and Drug Administration (FDA), potential limitations in the use of biologic therapy and the appropriate requirements for compliance with the FDA have been detailed in these guidelines. Regenerative medicine, platelet-rich plasma, medicinal signaling cells, mesenchymal stem cells, stromal vascular fraction, bone marrow concentrate, chronic low back pain, discogenic
Effectiveness of Slump Stretching on Low Back Pain: A Systematic Review and Meta-analysis 30590849 2018 12 27 1526-4637 2018 Dec 24 Pain medicine (Malden, Mass.) Pain Med Effectiveness of Slump Stretching on Low Back Pain: A Systematic Review and Meta-analysis. 10.1093/pm/pny208 The slump test is a type of neurodynamic test that is believed to evaluate the mechanosensitivity of the neuromeningeal structures within the vertebral canal. The objective of this review was to investigate (...) the effectiveness of slump stretching on back pain and disability in patients with low back pain (LBP). Wesearched eight electronic databases (PubMed/Medline, Scopus, Ovid, CINAHL, Embase, PEDro, Google Scholar, CENTRAL). The publication language was restricted to English, and we searched the full time period available for each database, up to October 2017. Our primary outcomes were pain and disability, and the secondary outcome was range of motion (ROM). We identified 12 eligible studies with 515 LBPpatients
Intra-articular Triamcinolone Versus Hyaluronate Injections for Low Back Pain With Symptoms Suggestive of Lumbar Zygapophyseal Joint Arthropathy: A Pragmatic, Double-Blind Randomized Controlled Trial. 29261533 2019 02 13 2019 02 15 1537-7385 97 4 2018 04 American journal of physical medicine & rehabilitation Am J Phys Med Rehabil Intra-articular Triamcinolone Versus Hyaluronate Injections for Low Back Pain With Symptoms Suggestive of Lumbar Zygapophyseal Joint Arthropathy: A Pragmatic, Double (...) -Blind Randomized Controlled Trial. 278-284 10.1097/PHM.0000000000000879 The aim of the study was to compare hyaluronate with triamcinolone injections in treating chronic low back pain suggestive of lumbar zygopophyseal joint arthropathy. This was a prospective, double-blind, randomized controlled trial. Thirty subjects were randomly assigned to receive bilateral L3-S1 lumbar zygopophyseal joint injections with triamcinolone (KA) or Synvisc-One (HA). Pain (visual analog scale) and Pain Disability
Combination Drug Therapy for the Management of Low Back Pain and Sciatica: Systematic Review and Meta-Analysis 30585164 2019 01 29 1528-8447 20 1 2019 Jan The journal of pain : official journal of the American Pain Society J Pain Combination Drug Therapy for the Management of Low Back Pain and Sciatica: Systematic Review and Meta-Analysis. 1-15 S1526-5900(18)30319-5 10.1016/j.jpain.2018.06.005 Combining medicines may give greater pain relief and/or improved tolerability. We conducted (...) a systematic review to investigate the effects of combination drug therapy in patients with low back pain and/or sciatica on pain, disability, and adverse events. Databases and trial registers were searched from inception to July 27, 2017, for randomized trials of (sub)acute or chronic back pain or sciatica participants that were administered combination drug therapy compared with monotherapy or placebo. Of the 27 studies included, most combinations (21 of 23) consisted of single trials. Most combinations
Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review 30649460 2019 01 16 1526-4637 2019 Jan 12 Pain medicine (Malden, Mass.) Pain Med Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review. 10.1093/pm/pny287 Low back pain (LBP) andneckpain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function (...) and facilitate a return to the patient's desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBPandneckpain. Using PRISMA guidelines, a search of the PubMed and CENTRAL
Evaluation of the Neuropathic Component of Chronic Low Back Pain 30222611 2018 12 06 1536-5409 35 1 2019 Jan The Clinical journal of pain Clin J Pain Evaluation of the Neuropathic Component of Chronic Low Back Pain. 7-17 10.1097/AJP.0000000000000653 Assessment of neuropathic pain in chronic lowback syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various (...) chronic low back pain syndromes using a range of diagnostic tests. Included in this study were 63 patients with chronic axial low back pain (ALBP), 48 patients with chronic radicular syndromes (CRS) comprising 23 with discogenic compression (CDRS) and 25 with lumbar spinal stenosis (LSS), and 74 controls. PainDETECT questionnaire (PDQ), quantitative sensory testing (QST), and skin biopsy with evaluation of intraepidermal nerve fiber density (IENFD) were used to assess the neuropathic pain component
A commonly used treatment does not improve chronic low back pain Signal - A commonly used treatment does not improve chronic low back pain Dissemination Centre Discover Portal NIHR DC Discover A commonly used treatment does not improve chronic low back pain Published on 7 November 2017 This trial found that destroying nerves that take pain signals to the brain using heat (radiofrequency denervation) did not improve pain, function or a sense of “recovery”. The treatment was used alongside (...) exercise and was a variation of the technique commonly used in the UK. In this large study, it was compared to exercise alone. Low back pain is usually short-lived, but some people develop long-term back pain which can negatively impact their lives. NICE recommends exercise, pain relief and self-management to cope with pain. If these treatments are not effective and pain is severe, then more intensive options, such as radiofrequency denervation can be considered. These findings suggest
Two nerve drugs are not suitable for treating long-term low back pain Signal - Two nerve drugs are not suitable for treating long-term low back pain Dissemination Centre Discover Portal NIHR DC Discover Two nerve drugs are not suitable for treating long-term low back pain Published on 5 December 2017 The drugs gabapentin and pregabalin (gabapentinoids) were found not to help lower back pain that had lasted more than three months. Gabapentin gave no benefit compared with placebo, while (...) pregabalin was less effective than other painkillers. Both were associated with several side effects, such as dizziness. Long-term low back pain without clear cause is very common. It causes considerable loss of productivity and places a high demand on the healthcare service. It is difficult to treat, and people often get limited relief from simple painkillers, causing practitioners to consider alternative options. This review gathered eight trials looking at gabapentinoids for adults with long-term
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: December 2018 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
Do Regenerative Medicine Therapies Provide Long-Term Relief in Chronic Low Back Pain: A Systematic Review and Metaanalysis 30508983 2018 12 04 2150-1149 21 6 2018 Nov Pain physician Pain Physician Do Regenerative Medicine Therapies Provide Long-Term Relief in Chronic Low Back Pain: A Systematic Review and Metaanalysis. 515-540 Several cell-based therapies have been proposed in recent years the management of low back pain, including the injection of medicinal signaling cells or mesenchymal stem (...) cells (MSCs) and platelet-rich plasma (PRP). However, there is only emerging clinical evidence to support their use at this time. To assess the effectiveness of MSCs or PRP injections in the treatment of lowback and lower extremity pain. A systematic review and metaanalysis of the effectiveness of PRP and MSCs injections in managing lowback and lower extremity pain. PubMed, Cochrane Library, US National Guideline Clearinghouse, prior systematic reviews, and reference lists. The literature search
Low back pain: Providing reassurance, encouraging activity and reducing reliance on imaging Low back pain | NPS MedicineWise 20 Years Of Helping Australians Make Better Decisions About Medicines, Medical Tests And Other Health Technologies. Log in Facebook Twitter LinkedIn Google Signing you in Use another account OR Login Form Email Password Log in to NPS MedicineWise Forgot password Forgot password Email Send reset instructions Set new password Reset Password Password Set password Account (...) for articles that match your past search terms. We’ll send you email alerts for articles that match these search terms: History Clear all to view your search history. Menu Breadcrumbs Low back painLow back pain Providing reassurance, encouraging activity and reducing reliance on imaging Share Share to: Larger text Smaller text Low back pain podcast Low back pain is a complex and challenging condition. It affects people of all ages and is the leading cause of disability in the world. Unfortunately, many
The effect of lumbosacral orthosis on the thickness of deep trunk muscles using ultrasound imaging: A randomized controlled trial in patients with chronic low back pain. 30652982 2019 01 17 1537-7385 2019 Jan 15 American journal of physical medicine & rehabilitation Am J Phys Med Rehabil The effect of lumbosacral orthosis on the thickness of deep trunk muscles using ultrasound imaging: A randomized controlled trial in patients with chronic low back pain. 10.1097/PHM.0000000000001135 This study (...) was conducted to evaluate the changes occurring in the thickness of deep trunk muscles, measured using ultrasound imaging, after four weeks of lumbosacral orthosis (LSO) use in conjunction with routine physical therapy. This parallel-group, randomized, controlled trial was conducted on 44 patients with nonspecific chronic low back pain (CLBP), randomly allocated to the experimental and control groups. Both groups received eight sessions of physical therapy twice per week for four weeks. The experimental
Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham-Controlled Pilot Study 30268803 2018 11 25 1528-8447 2018 Sep 27 The journal of pain : official journal of the American Pain Society J Pain Identifying and Engaging Neuronal Oscillations by Transcranial Alternating Current Stimulation in Patients With Chronic Low Back Pain: A Randomized, Crossover, Double-Blind, Sham (...) stimulation as a nonpharmacological treatment option. We hypothesized that alpha oscillations, a prominent thalamocortical activity pattern in the human brain, are impaired in chronic pain and can be modulated with transcranial alternating current stimulation (tACS). We performed a randomized, crossover, double-blind, sham-controlled study in patients with chronic low back pain (CLBP) to investigate how alpha oscillations relate to pain symptoms for target identification and whether tACS can engage
Low back pain patients' perspectives on long-term adherence to home-based exercise programmes in physiotherapy. 30317015 2018 11 29 2468-7812 38 2018 12 Musculoskeletal science & practice Musculoskelet Sci Pract Low back pain patients' perspectives on long-term adherence to home-based exercise programmes in physiotherapy. 77-82 S2468-7812(18)30340-0 10.1016/j.msksp.2018.09.002 Adherence to an exercise programme impacts the outcome of physiotherapy treatment in patients with non-specific low back pain (...) . The aim of this study was to explore the patients' perspectives on long term adherence to such exercise programmes. This qualitative study was embedded in a randomised controlled trial (RCT) which compared the effectiveness of two types of exercise programme on patients with nonspecific low back pain. Answers from 44 participants to three open-ended questions were analysed using thematic analysis. Patients' perceptions related to the following themes: 1) the role of knowledge in long-term exercise
The Effect of Combination Pharmacotherapy on Low Back Pain: A Meta-analysis 29727303 2018 10 04 1536-5409 34 11 2018 Nov The Clinical journal of pain Clin J Pain The Effect of Combination Pharmacotherapy on Low Back Pain: A Meta-analysis. 1039-1046 10.1097/AJP.0000000000000622 To evaluate the difference between combination pharmacotherapy and monotherapy on low back pain (LBP). Wesearched PubMed, Embase, and Cochrane Central Register of Controlled Trials databases up to March 14, 2017. Two (...) authors independently extracted the data and assessed the validity of included trials. Twelve randomized controlled trials comparing the effect of LBPcombinationpharmacotherapy to monotherapy or placebo were included. In chronic LBP, combinationpharmacotherapy was more effective than placebo in pain relief (P<0.001; standardized mean difference [SMD], -0.50; 95% confidence interval [CI], -0.70 to -0.29; I²=0%) and function improvement (P<0.001; SMD, -0.27; 95% CI, -0.41 to -0.13; I²=0%) and showed
Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial 30285054 2018 11 05 2168-6114 178 11 2018 Nov 01 JAMA internal medicine JAMA Intern Med Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial. 1474-1481 10.1001/jamainternmed.2018.4222 Antidepressants at low dose are commonly prescribed for the management of chronic low back pain and their use is recommended in international clinical guidelines. However (...) , there is no evidence for their efficacy. To examine the efficacy of a low-dose antidepressant compared with an active comparator in reducing pain, disability, and work absence and hindrance in individuals with chronic low back pain. A double-blind, randomized clinical trial with a 6-month follow-up of adults with chronic, nonspecific, low back pain who were recruited through hospital/medical clinics and advertising was carried out. Low-dose amitriptyline (25 mg/d) or an active comparator (benztropine mesylate, 1
Effectiveness and Downstream Healthcare Utilization for Patients That Received Early Physical Therapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial 29489568 2018 09 17 1528-1159 43 19 2018 Oct 01 Spine Spine Effectiveness and Downstream Healthcare Utilization for Patients That Received Early Physical Therapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial. 1313-1321 10.1097/BRS.0000000000002619 Randomized controlled trial. The aim of this study was to compare (...) early physical therapy versus usual care in patients with low back pain. Early physical therapy (PT) has been associated with reduced downstream healthcare utilization in retrospective studies, but not investigated prospectively in the military health system. Military service members seeking care from a general practitioner were recruited. Patients attended a 20-minute self-management class with focus on psychosocial resilience and then randomized to usual care only (UC) versus immediately starting
Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial 29787734 2018 08 31 1532-821X 99 9 2018 Sep Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial. 1720-1729 S0003-9993(18)30295-8 10.1016/j.apmr.2018.04.022 (...) To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP). Parallel group randomized controlled trial. Private and institutional health centers. Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months. Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33
Cognitive behavioural therapy may help people with persistent low back pain Signal - Cognitive behavioural therapy may help people with persistent low back pain Dissemination Centre Discover Portal NIHR DC Discover Cognitive behavioural therapy may help people with persistent low back pain Published on 14 October 2015 This NIHR-funded systematic review aimed to assess the effectiveness of talking therapies in improving outcomes for people with non-specific low back pain. It found that cognitive (...) the number of older people experiencing lower back pain and the risk of ongoing problems for those with recent symptoms. However, the review included many different interventions, many of which were not properly described, which limit the uptake and implementation of findings in practice. It is likely that a substantial increase in NHS capacity would be needed to deliver cognitive behavioural therapies for the many people with persistent low back pain. This may be important though, as the provision