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Latest & greatest articles for low back pain
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Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis 29602304 2018 06 01 1938-1344 48 6 2018 Jun The Journal of orthopaedic and sports physical therapy J Orthop Sports Phys Ther Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis. 476-490 10.2519/jospt.2018.7562 Study Design Literature review with meta-analysis. Background (...) The McKenzie Method of Mechanical Diagnosis and Therapy (MDT), a classification-based system, was designed to classify patients into homogeneous subgroups to direct treatment. Objectives To examine the effectiveness of MDT for improving pain and disability in patients with either acute (less than 12 weeks in duration) or chronic (greater than 12 weeks in duration) low back pain (LBP). MethodsRandomized controlled trials examining MDT in patients with LBPwereidentified from 6 databases. Independent
Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic Low Back Pain 29669086 2018 04 18 1538-6724 98 5 2018 May 01 Physical therapy Phys Ther Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic Low Back Pain. 369-380 10.1093/ptj/pzy026 Chronic low back pain (CLBP) is highly prevalent in older adults, leading to functional decline. The objective of this study was to evaluate physical (...) activity (PA) only and PA plus cognitive-behavioral therapy for pain (CBT-P) among older adult veterans with CLBP. This study was a pilot randomized trial comparing a 12-week telephone-supported PA-only intervention group (PA group) or PA plus CBT-P intervention group (PA + CBT-P group) and a wait-list control group (WL group). The study setting was the Durham Veterans Affairs Health Care System. The study participants were 60 older adults with CLBP. The PA intervention included stretching, strengthening
Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis 29565945 2018 03 22 2150-1149 21 2 2018 Mar Pain physician Pain Physician Is Vitamin D Supplementation Effective for Low Back Pain? A Systematic Review and Meta-Analysis. 121-145 Low back pain (LBP) isthe leading cause of years lived with disability worldwide. Current intervention strategies are failing to reduce the enormous global burden of LBPandare prompting researchers to investigate (...) alternative management strategies, such as vitamin D supplementation. Vitamin D supplementation appears to down regulate pro-inflammatory cytokines which lead to pain and up regulate anti-inflammatory cytokines that reduce inflammation. These mechanisms might explain the increasing interest in the use of vitamin D supplementation for LBP. Todetermine whether vitamin D supplementation improves pain more than a control intervention for individuals with LBP. Thisstudy was conducted in accordance
Cognitive behavioural therapy may help people with persistent low back pain NIHR DC | Signal - Cognitive behavioural therapy may help people with persistent low back pain Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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 (...) for decision makers, given 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
A commonly used treatment does not improve chronic low back pain NIHR DC | Signal - A commonly used treatment does not improve chronic low back pain Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal 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
Two nerve drugs are not suitable for treating long-term low back pain NIHR DC | 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
Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial 29333872 2018 01 15 1477-0873 2018 Jan 01 Clinical rehabilitation Clin Rehabil Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial. 269215517753972 10.1177/0269215517753972 To investigate the effects that wearing unstable shoes has on disability, trunk muscle activity, and lumbar spine range of motion (ROM) in patients with chronic (...) lower back pain (CLBP). Randomized controlled trial. Orthopedic Surgery Service. We randomized 40 adults with nonspecific CLBP either to an unstable shoes group ( n = 20) or to the control group ( n = 20). The participants in the unstable shoes group were advised to wear these shoes for a minimum of six hours a day for four weeks. Control group participants were asked to continue wearing their regular shoes. Our primary outcome was measurement of back-related dysfunction, assessed using the Roland
What low back pain is and why we need to pay attention. Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause (...) of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people
Low back pain: a call for action. Low back pain is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population. 1 Because these population shifts are more rapid in low-income and middle-income countries, where adequate resources to address the problem might not exist, the effects will probably be more extreme in these regions. Most low back pain is unrelated to specific identifiable spinal abnormalities, and our Viewpoint (...) , the third paper in this Lancet Series, 2,3 is a call for action on this global problem of low back pain.
Prevention and treatment of low back pain: evidence, challenges, and promising directions. Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms (...) . Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related
Implication of Two Different Doses of Intradiscal Ozone-Oxygen Injection upon the Pain Alleviation in Patients with Low Back Pain: A Randomized, Single-Blind Study 29357333 2018 01 22 2150-1149 21 1 2018 Jan Pain physician Pain Physician Implication of Two Different Doses of Intradiscal Ozone-Oxygen Injection upon the Pain Alleviation in Patients with Low Back Pain: A Randomized, Single-Blind Study. E25-E31 Low back pain (LBP) ismostly induced by disc herniation (DH) or degeneration and has (...) scores after 6 months in both of the groups. This study was limited by a small sample size; it was also an active control trial, which may explain the insignificant difference in between the groups, in addition to being a single-blind trial. Intradiscal injection of O₃-O₂ mixture is a very valuable maneuver in the reduction of DH size and improvement of pain quality, with either ozone concentrations of 40 µg/mL or 30 µg/mL. Low back pain, ozone, disc herniation. Elawamy Abdelraheem A Department
Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis 29371112 2018 02 11 1878-1632 2018 Jan 31 The spine journal : official journal of the North American Spine Society Spine J Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. S1529-9430(18)30016-0 10.1016/j.spinee.2018.01.013 Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However (...) , questions remain about their efficacy, dosing, safety, and how these approaches compare with other therapies. The present study aims to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain. This is a systematic literature review and meta-analysis. The present study measures self-reported pain, function, health-related quality of life, and adverse events. We identified studies by searching multiple electronic databases
Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial 29138049 2018 02 08 1532-821X 99 2 2018 Feb Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial. 338-347 S0003-9993(17)31343-6 10.1016/j.apmr.2017.10.016 To assess the effect of a pain neurophysiology (...) education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). Single-blind randomized controlled trial. Private clinic and university. Patients with CLBP for ≥6 months (N=56). Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants. The primary outcome
The clinical utility of lumbar discography for assessing low back pain: impact on patient management and health outcomes The clinical utility of lumbar discography for assessing low back pain: impact on patient management and health outcomes The clinical utility of lumbar discography for assessing low back pain: impact on patient management and health outcomes HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. The clinical utility of lumbar discography for assessing low back pain: impact on patient management and health outcomes. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Rationale: Discography evaluates the suspected culprit discs with abnormal morphology and, as a control, normal discs. In theory, the combination of imaging that demonstrates disc degeneration or internal disc
Facet-joint injections for non-specific low back pain: a feasibility RCT Facet-joint injections for non-specific low back pain: a feasibility RCT Facet-joint injections for non-specific low back pain: a feasibility RCT Snidvongs S, Taylor R S, Ahmad A, Thomson S, Sharma M, Farr A, Fitzsimmons D, Poulton S, Mehta V & Langford R Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Snidvongs S, Taylor R S, Ahmad A, Thomson S, Sharma M, Farr A, Fitzsimmons D, Poulton S, Mehta V & Langford R. Facet-joint injections for non-specific low back pain: a feasibility RCT. Health Technology Assessment 2017; 21(74) Authors' objectives To assess the feasibility of carrying out a definitive study to evaluate the clinical effectiveness and cost-effectiveness of lumbar facet-joint injections compared with a sham procedure in patients with non-specific 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: August 2018 Last updated: March 2018 Summary A 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 disc disease. Degenerative disc disease leads (...) -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 disc disease. The pain
A Randomized, Double-Blind, Placebo-Controlled Trial of Naproxen With or Without Orphenadrine or Methocarbamol for Acute Low Back Pain 29089169 2017 12 19 1097-6760 2017 Oct 28 Annals of emergency medicine Ann Emerg Med A Randomized, Double-Blind, Placebo-Controlled Trial of Naproxen With or Without Orphenadrine or Methocarbamol for Acute Low Back Pain. S0196-0644(17)31700-6 10.1016/j.annemergmed.2017.09.031 In US emergency departments (EDs), patients with low back pain are often treated (...) with nonsteroidal anti-inflammatory drugs and muscle relaxants. We compare functional outcomes among patients randomized to a 1-week course of naproxen+placebo versus naproxen+orphenadrine or naproxen+methocarbamol. This was a randomized, double-blind, comparative effectiveness trial conducted in 2 urban EDs. Patients presenting with acute, nontraumatic, nonradicular low back pain were enrolled. The primary outcome was improvement on the Roland-Morris Disability Questionnaire (RMDQ) between ED discharge and 1 week later. All patients
Movement System Impairment-Based Classification Treatment Versus General Exercises for Chronic Low Back Pain: Randomized Controlled Trial 29077963 2017 12 22 1538-6724 98 1 2018 Jan 01 Physical therapy Phys Ther Movement System Impairment-Based Classification Treatment Versus General Exercises for Chronic Low Back Pain: Randomized Controlled Trial. 28-39 10.1093/ptj/pzx094 Treatment for chronic low back pain (LBP) includesdifferent forms of exercises, that to date have resulted in only small (...) to moderate treatment effects. To enhance the treatment effects, different classification systems have been developed to classify people with LBPintomore homogeneous subgroups leading to specific treatments for each subgroup. The purpose of this study was to compare the efficacy of a treatment based on the Movement System Impairment (MSI) model with a treatment consisting of symptom-guided stretching and strengthening exercises in people with chronic LBP. Thestudy was a 2-arm, prospectively registered