The Lancet Volume 378, No. 9802, p1560–1571, 29 October 2011 Summary Background Back pain remains a challenge for primary care internationally. One model that has not been tested is stratification of the management according to the patient’s prognosis (low, medium, or high risk). We compared the clinical effectiveness and cost-effectiveness of stratified primary care (intervention) […]
Practice points LBP affects between 14% and 80% of working-aged people, depending on case definition. Disc protrusion and disc degeneration, as determined by MRI, are strongly associated with LBP. Work-related factors, including heavy lifting and frequent bending and twisting, are associated with lumbar disc disease. Population studies of cervical pain and cervical disc disease have lagged behind […]
Mark Johnson, D.O. Evidence-Based Answers From The Family Physicians Inquires Network Clinical Inquires Short courses of systemic steroids are likely safe, but they are ineffective. A single dose of intramuscular (IM) or intravenous (FV) methylprednisolone doesn’t improve long-term pain scores in patients with low back pain and sciatica and produces conflicting effects on furiction. Oral prednisone (9-day taper) doesn’t improve pain or […]
Foster R,et al. Neuroscience. 2011 Jun 2;183:230-7. doi: 10.1016/j.neuroscience.2011.03.035. Epub 2011 Mar 30. Affiliation Department of Urology, Loyola University Health System, Maywood, IL, USA. Abstract Visceral sensory afferents during disease or following injury often produce vague, diffuse body sensations, and pain referred to somatic targets. Alternatively, injury due to trauma or disease of somatic nerve […]
February 14, 2011 Roughly 3.4 million emergency department visits, or an average of 9,400 visits a day, that occurred at U.S. hospitals in 2008 were related to back problems, according to a press release from Agency for Healthcare Research and Quality. In addition, more than 663,000 inpatient stays — a daily average of nearly 1,820 stays […]
Walker, Bruce F DC Spine: 1 February 2011 – Volume 36 – Issue 3 – p 230–242 Journal Reference Abstract Study Design. Cochrane systematic review of randomized controlled trials. Objective. To determine the effects of combined chiropractic interventions on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with low-back pain (LBP). Summary […]
T. Kuijpers European Spine Journal January 2011, Volume 20, Issue 1, pp 40-50 First online: 31 July 2010 Abstract The objective of this review was to determine the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP). Existing Cochrane reviews for the four interventions […]
A Systematic Review Endean, Alison MBChB, MRCP Spine: 15 January 2011 – Volume 36 – Issue 2 – p 160–169 Abstract Study Design. Systematic review and meta-analysis. Objective. To assess how confidently low back pain (LBP) can be attributed to abnormalities on magnetic resonance imaging (MRI), and thereby explore the potential value of MRI abnormalities […]
Depalma MJ, et al. PM R. 2011 Jan;3(1):33-9. doi: 10.1016/j.pmrj.2010.09.006. Abstract OBJECTIVE: To evaluate the predictive utility of the pattern of low back pain (LBP) in detecting the source of LBP as internal disk disruption (IDD), facet joint pain (FJP), or sacroiliac joint pain (SIJP). DESIGN: Retrospective chart review. SETTING: University spine center. PATIENT SAMPLE: […]
J Bone Joint Surg Am. 2011 Jan 5;93(1):29-37. doi: 10.2106/JBJS.I.01348. Passias PG, Wang S, Kozanek M, Xia Q, Li W, Grottkau B, Wood KB, Li G. Abstract BACKGROUND: Little information is available on vertebral motion in patients with discogenic low back pain under physiological conditions. We previously validated a combined dual fluoroscopic and magnetic resonance […]
J Orthop Sports Phys Ther. 2011 Mar;41(3):141-8. doi: 10.2519/jospt.2011.3437. Epub 2011 Jan 4. Hagins M, Lamberg EM. Abstract STUDY DESIGN: Case control, repeated-measures, experimental laboratory study. OBJECTIVE: To determine if, during a whole-body lifting task, individuals with low back pain (LBP) breathe differently than age-matched controls. BACKGROUND: Breath control may be optimized to provide increased […]
Spine J. 2010 Dec;10(12):1055-64. doi: 10.1016/j.spinee.2010.08.019. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Bishop PB, Quon JA, Fisher CG, Dvorak MF. Abstract BACKGROUND CONTEXT: Evidence-based clinical practice guidelines (CPGs) […]
Furlan AD, et al. Show all Journal Evid Rep Technol Assess (Full Rep). 2010 Oct;(194):1-764. Abstract BACKGROUND: Back and neck pain are important health problems with serious societal and economic implications. Conventional treatments have been shown to have limited benefit in improving patient outcomes. Complementary and Alternative Medicine (CAM) therapies offer additional options in the […]
J Manipulative Physiol Ther. 2010 Nov-Dec;33(9):640-3. doi: 10.1016/j.jmpt.2010.08.018. Epub 2010 Oct 18. Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer. Liliedahl RL1, Finch MD, Axene DV, Goertz CM. Author information Abstract OBJECTIVE: The primary aim of this study was to […]
Pro-inflammatory cytokines expression increases following low-and high-magnitude cyclic loading of lumbar ligaments D’Ambrosia P, et al. Eur Spine J. 2010 Aug;19(8):1330-9. doi: 10.1007/s00586-010-1371-4. Epub 2010 Mar 25. Abstract Repetitive or overuse disorders of the lumbar spine affect the lives of workers and athletes. We hypothesize that repetitive anterior lumbar flexion-extension under low or high load […]
Spine J. 2010 Jun;10(6):514-29. doi: 10.1016/j.spinee.2010.03.032. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Dagenais S, Tricco AC, Haldeman S. Abstract BACKGROUND CONTEXT: Low back pain (LBP) is a prevalent, costly, and challenging condition to manage. Clinicians must choose among numerous assessment and management options. Several […]
RT Benson Ann R Coll Surg Engl. Mar 2010; 92(2): 147–153. Abstract INTRODUCTION The natural history of a lumbar hernia of the nucleus pulposus (HNP) is not fully known and clear indications for operative intervention cannot be established from the literature. Several studies have shown that the largest discs appear to have the greatest tendency […]
Medscape.com The Association between Lumbar Disc Degeneration and Low Back Pain: The Influence of Age, Gender, and Individual Radiographic Features Evelien I. T. de Schepper, MD, Jurgen Damen, MD, Joyce B. J. van Meurs, PhD, Abida Z. Ginai, MD, Maria Popham, MSc, Albert Hofman, PhD, Bart W. Koes, PhD, Sita M. Bierma-Zeinstra, PhDDisclosures Spine. 2010;35(5):531-536. […]
Gert Bronfort, Mitch Haas, Roni Evans, Brent Leininger and Jay Triano Chiropractic & Osteopathy 2010, 18:3 Abstract Background The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. Methods The conclusions […]
Low Back Pain and Best Practice Care A Survey of General Practice Physicians Christopher M. Williams, MAppSc Arch Intern Med. 2010;170(3):271-277. doi:10.1001/archinternmed.2009.507. ABSTRACT Background Acute low back pain (LBP) is primarily managed in general practice. We aimed to describe the usual care provided by general practitioners (GPs) and to compare this with recommendations of best […]