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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 pain Low 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
Local infiltration analgesia versus interscalene nerve block for postoperative pain control after shoulder arthroplasty: a prospective, randomized, comparative noninferiority study involving 99 patients The aim of this study was to compare the efficacy of local infiltration analgesia (LIA) and interscalene nerve block (ISB) for early postoperative pain control after total shoulder arthroplasty (TSA). The hypothesis was that LIA is not inferior to ISB.A prospective, randomized controlled study (...) , which was then removed. The primary outcome was the mean shoulder pain score for the 48-hour postoperative period on a numerical scale (0-10). The secondary outcomes were postoperative opioid requirements, complications, and shoulder function at the 1-month follow-up visit. The sample size was calculated for a noninferiority study.The study included 99 patients (50 LIA and 49 ISB patients) with a mean age of 72 ± 9.6 years. Although no significant difference in the mean pain score was found between
Intra-articular Steroids vs Saline for Lumbar Z-Joint Pain: A Prospective, Randomized, Double-Blind Placebo-Controlled Trial To determine if intra-articular (IA) injection of corticosteroids is effective in reducing the need for radiofrequency ablation (RFA) in those with dual comparative medial branch block (MBB)-confirmed lumbar z-joint pain.This was a randomized, double blind, placebo-controlled study.Two academic medical centers.Fifty-six consecutive subjects who had ≥80% pain relief during (...) an initial screening MBB were recruited.Patients received a second confirmatory MBB and concurrent IA injection of either corticosteroid or saline per randomization. Twenty-nine of 56 received intra-articular corticosteroid (triamcinolone 20 mg), of whom 24 also had a positive confirmatory MBB per Spine Interventional Society guidelines, with ≥80% pain relief from both MBBs. Twenty-seven of 56 received IA saline into the z-joint during the confirmatory MBB, of whom 22 also had a positive confirmatory MBB
Pulsed Ultrasounds Reduce Pain and Disability, Increasing Rib Fracture Healing, in a Randomized Controlled Trial Rib fractures are an important health issue worldwide, with significant, pain, morbidity, and disability for which only symptomatic treatment exists.Based on our previous experimental model, the objective of the current study was to assess for the first time whether pulsed ultrasound (PUS) application could have beneficial effects on humans.Prospective, double-blinded, randomized (...) , controlled trial of 51 patients. Four were excluded, and 47 were randomized into the control group (N = 23) or PUS group (N = 24). The control group received a PUS procedure without emission, and the PUS group received 1 Mhz, 0.5 W/cm2 for 1 min/cm2. Pain level, bone callus healing rate, physical and work activity, pain medication intake, and adverse events were blindly evaluated at baseline and one, three, and six months.There were no significant differences at baseline between groups. PUS treatment
Fulranumab as Adjunctive Therapy for Cancer-Related Pain: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study This randomized, double-blind (DB), placebo-controlled, phase 2 study assessed the efficacy and safety of fulranumab as a pain therapy adjunctive to opioids in terminally ill cancer patients. Ninety-eight patients were randomized (2:1) to receive one subcutaneous injection of fulranumab (9 mg) or placebo in the 4-week DB phase. Seventy-one (72%) patients entered (...) the 48-week open-label extension phase and were administered 9 mg of fulranumab every 4 weeks. The study failed to demonstrated efficacy at the end of the DB phase (primary endpoint, mean [SD] change in average cancer-related pain intensity was -.8 (1.26) for fulranumab and -.7 (1.56) for placebo; P = .592). However, potential benefit is suggested based on secondary endpoints (30% responder rate [P = .020], Brief Pain Inventory-Short Form [BPI-SF] pain intensity subscale [P = .003], and pain
Addition of dexmedetomidine or fentanyl to ropivacaine for transversus abdominis plane block: evaluation of effect on postoperative pain and quality of recovery in gynecological surgery Transversus abdominis plane (TAP) block is reportedly a preferable technique for reducing postoperative pain in abdominal surgeries. The aim of this study was to compare the analgesic efficacy and recovery quality after gynecological surgery by adding dexmedetomidine or fentanyl into an ultrasound-guided TAP
Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial Neuropathic pain is an unavoidable treatment-related adverse event among patients with head and neck cancer who are undergoing radiotherapy. We aimed to test the efficacy and safety of pregabalin versus placebo in the treatment of radiotherapy-related neuropathic pain.This randomized, double-blind, placebo-controlled trial was conducted in four centers in China (...) . Eligible patients with a mean pain intensity score of 4 or more on an 11-point numeric rating scale were randomly assigned to receive either active treatment with a flexible dose of pregabalin or placebo for 16 weeks. The primary efficacy outcome was pain reduction measured on the numeric rating scale.There were 128 patients who received treatment as randomly assigned. Pain intensity reduction was 2.44 in the pregabalin arm and 1.58 in the placebo arm at week 16, yielding an adjusted mean difference
The efficacy of electromyographic biofeedback on pain, function, and maximal thickness of vastus medialis oblique muscle in patients with knee osteoarthritis: a randomized clinical trial The aim of this survey was to examine the effect of adding electromyographic biofeedback (EMGBF) to isometric exercise, on pain, function, thickness, and maximal electrical activity in isometric contraction of the vastus medialis oblique (VMO) muscle in patients with knee osteoarthritis (OA).In this clinical (...) , except for VAS score. VMO muscle thickness did not change significantly after exercise therapy in either of the groups.Isometric exercises accompanied by EMGBF and the same exercises without biofeedback for 2 months both led to significant improvements in pain and function of patients with knee OA. Real EMGBF was not superior to exercise without biofeedback in any of the measured variables, except for VAS score.
The effect of position change on vital signs, back pain and vascular complications following percutaneous coronary intervention To determine the effect of position change that is applied after percutaneous coronary intervention on vital signs, back pain and vascular complications.In order to minimise the postprocedural complications, patients are restricted to prolonged bed rest that is always accompanied by back pain and haemodynamic instability.Randomised-controlled quasi-experimental (...) in the EG, the systolic blood pressure (T4-T6), the rate of postprocedural vascular complications (1%) and the back pain scores were significantly lower (between T5-T6) than the CG, also, the back pain was the lowest level in the standard fowler's position in the 6th hr wherein the HOB was elevated by 45-60°.It was found that systolic blood pressure and back pain were at the lowest levels in the standard fowler's position in the 6th hr after the procedure when the HOB was elevated 45-60° and the result
Randomized Clinical Trial of Intravenous Acetaminophen as an Analgesic Adjunct for Older Adults With Acute Severe Pain Older adults are at risk for undertreatment of pain. We examined intravenous (IV) acetaminophen as an analgesic adjunct to IV opioids in the care of older emergency department (ED) patients with acute severe pain.This was a randomized clinical trial conducted in two EDs in the Bronx, New York. Eligible adults aged 65 years and older with acute severe pain were randomized to 0.5 (...) mg of IV hydromorphone and 1 g of IV acetaminophen or 0.5 mg of IV hydromorphone and 100 mL of normal saline placebo. The primary outcome was the between group difference in improvement of numerical rating scale (NRS) pain scores at 60 minutes. Secondary outcomes were the between-group differences in the proportion of patients who chose to forgo additional pain medications at 60 minutes; the proportion who developed side effects; the proportion who required rescue analgesia; and between-group
The effect of early intervention of mirror visual feedback on pain, disability and motor function following hand reconstructive surgery: a randomized clinical trial To determine the effect of mirror visual feedback (MVF) on disability, pain, and motor function on patients who underwent hand reconstructive surgery.Randomized, single-blinded controlled trial.Rehabilitation center.A total of 40 patients who were randomly assigned into the intervention group ( n = 20) and control group ( n = 20 (...) ) participated in this study.The rehabilitation sessions took place twice a week for eight weeks. The control group received traditional rehabilitation for 75 minutes. While the intervention group performed MVF and traditional rehabilitation for 30 and 45 minutes, respectively.Pain and disability of the hand were assessed with McGill pain questionnaire and Disability of Arm, Shoulder, and Hand (DASH) scores. The range of joint motion was evaluated by Goniometer, and the strength of grip and pinch
A Novel Technique of Saddle Rhizotomy Using Thermal Radiofrequency for Intractable Perineal Pain in Pelvic Malignancy: A Pilot Study The prevalence of pain in advanced pelvic cancer may reach up to 95%. Control of such pain is often difficult owing to a variety of neuroanatomical and functional peculiarities. Different modalities have been utilized to treat this pain including saddle chemical rhizolysis with the potential for jeopardizing the neural control of the sphincters.The aim (...) of this pilot study is to determine the feasibility of using selective thermal radiofrequency as an alternative to saddle chemical rhizolysis in patients with refractory perineal pain associated with pelvic malignancies.Pilot study.Pain Relief Department of the National Cancer Institute, Cairo University.Forty patients, 18 years of age or older, who had pelvic malignancy and were complaining of moderate or severe perineal pain not controlled with maximum tolerable doses of morphine sulfate for at least 4
Effect of Intrathecal Baclofen on Pain and Quality of Life in Poststroke Spasticity Background and Purpose- Intrathecal baclofen (ITB) is an effective treatment for managing patients with severe poststroke spasticity, who can experience continued pain and decline in their quality of life (QoL). SISTERS (Spasticity In Stroke-Randomized Study) was a randomized, controlled, open-label, multicenter, phase 4 study to evaluate ITB therapy versus conventional medical management (CMM) with oral (...) antispastic medications for treatment of poststroke spasticity. Methods- Poststroke patients with spasticity in ≥2 extremities and an Ashworth Scale score of ≥3 in ≥2 affected lower extremity muscle groups were randomized (1:1) to ITB (N=31) or CMM (N=29). Both treatment arms received physiotherapy throughout. The primary outcome was the change in average Ashworth Scale score in the lower extremities of the affected side from baseline to month 6. Here, we report results for secondary outcomes: pain via
A prospective, randomized study evaluating the pain felt during intrauterine device insertion by the direct technique vs conventional technique. To assess the value of the direct insertion technique compared to the conventional insertion technique in reducing the pain experienced during placement of an intrauterine device (IUD).A prospective, controlled, randomized, single-blind trial was conducted in women eligible for IUD insertion. Participants were randomized into two groups: "conventional (...) placement" and "direct placement". The primary endpoint was the percentage of women reporting pain scored as ≥ 4 on the Numerical Verbal Rating Scale (NVRS) at IUD release. Secondary endpoints comprised the number of immediate incidents (insertion failure, vasovagal reaction, and IUD expulsion), the correct positioning of the IUD, checked by ultrasound, the occurrence of incidents within the week following IUD insertion, and the operators' evaluation of the procedure.A total of 60 patients were enrolled
Comparison of the Effectiveness of Two Different Methods of Decreasing Pain During Phlebotomy in Children: A Randomized Controlled Trial. The purpose of this study was to examine the effect of the applications of external cold and vibration and blowing soap bubbles during phlebotomy in children aged between 3 and 6 years.This study is a randomized controlled trial.The sample was obtained using block randomization. Children were divided into three groups: "external cold and vibration group (...) ," "blowing soap bubbles group," and "control group." Children, their parents, the nurse, and the researcher rated the children's pain during phlebotomy.A statistically significant difference between groups was found on pain scores. Pain scores were lower in the groups of external cold and vibration, and blowing soap bubbles than the control group.The methods of external cold and vibration and blowing soap bubbles had a pain relieving effect in children aged between 3 and 6 years during
Care of the older person: Evidence that active pain treatment improves sleep quality and quantity in people with depression and dementia Evidence that active pain treatment improves sleep quality and quantity in people with depression and dementia | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your (...) username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Evidence that active pain treatment improves sleep quality and quantity in people with depression and dementia Article Text Commentary Care of the older person Evidence that active pain treatment improves sleep quality and quantity in people with depression and dementia Amelia Swift Statistics from Altmetric.com Commentary on : Blytt KM, Bjorvatn B, Husebo B
Child health: Maternal dominance and reliance on over-the-counter analgesia can hinder development of healthy coping strategies for adolescents in pain Maternal dominance and reliance on over-the-counter analgesia can hinder development of healthy coping strategies for adolescents in pain | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search (...) for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Maternal dominance and reliance on over-the-counter analgesia can hinder development of healthy coping strategies for adolescents in pain Article Text Commentary Child health Maternal dominance and reliance on over-the-counter analgesia can hinder development of healthy coping strategies for adolescents in pain Amelia Swift
Greater trochanteric pain syndrome (trochanteric bursitis): When should I suspect greater trochanteric pain syndrome? Diagnosis | Diagnosis | Greater trochanteric pain syndrome (trochanteric bursitis) | CKS | NICE Search CKS… Menu Diagnosis Greater trochanteric pain syndrome (trochanteric bursitis): When should I suspect greater trochanteric pain syndrome? Last revised in August 2016 When should I suspect greater trochanteric pain syndrome? The diagnosis of greater trochanteric pain syndrome (...) is made on clinical grounds: Ask about the location, radiation, nature, and onset of pain, and what aggravates or relieves it. Greater trochanteric pain syndrome typically presents with pain in the area of the greater trochanter that may radiate down the lateral aspect of the thigh. The pain is described as deep, aching, or burning. The onset is usually gradual, but may be sudden. The pain is typically aggravated by physical activity, and is worse at night, especially when lying on the affected side