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Low back pain AND physical therapy

Jonas Verbrugghe, Anouk Agten, Bert O Eijnde, Enzo Olivieri, Xavier Huybrechts, Henk Seelen, Frank Vandenabeele, Annick Timmermans
BACKGROUND: Although low to moderate intensity exercise therapy is a predominant part of rehabilitation in nonspecific chronic low back pain (NSCLBP), effect sizes are small and optimal exercise modalities/intensities are unclear. Conversely, effects of high intensity training have not yet been investigated in this population. OBJECTIVE: The aim of this study is to investigate the feasibility of high intensity training (HIT) and to explore the magnitude of the effects of a HIT program may have on exercise capacity and disease related outcome measures compared to conventional therapy for persons with NSCLBP...
March 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Yong-Peng Lin, Yong-Jin Li, Bo-Lai Chen, Yu-Hai Guo
RATIONALE: Adult spinal epidermoid cyst (SEC) is a rare tumor. Lumbar laminectomy and tumor removal was a routine surgical procedure for adult spinal epidermoid cyst according to the literature, but postoperative lumbar instability and intractable low back pain may occur. In this study, we presented a brief report of an adult lumbar epidermoid cyst and introduced another surgical approach. PATIENT CONCERNS: This 28-year-old woman has been complaining of the severe right buttock pain and right thigh radiating pain for half a year...
January 2018: Medicine (Baltimore)
Daniel Rhon, Robert Miller, Julie Fritz
STUDY DESIGN: Randomized controlled trial OBJECTIVE.: Compare early physical therapy versus usual care in patients with low back pain. SUMMARY OF BACKGROUND DATA: Early physical therapy (PT) has been associated with reduced downstream healthcare utilization in retrospective studies, but not investigated prospectively in the military health system. METHODS: 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 a 3-week physical therapy program (PT)...
February 27, 2018: Spine
Timothy Y Mariano, Richard D Urman, Catherine A Hutchison, Robert N Jamison, Robert R Edwards
PURPOSE OF REVIEW: Chronic low back pain (CLBP) is a major source of physical and psychiatric morbidity and mortality, and the current overreliance on opioid analgesics has contributed to a burgeoning epidemic in the USA. Cognitive behavioral therapy (CBT) is an empirically supported treatment for CLBP, but little information exists regarding its potential efficacy for CLBP's precursor condition, subacute low back pain (sALBP), defined here as having a 7-12-week duration. Earlier intervention with CBT at the sALBP stage could produce larger clinical benefits...
February 23, 2018: Current Pain and Headache Reports
William M Rambo
INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization...
February 10, 2018: International Journal of Surgery Case Reports
Thomas Stowell, Ronald Schenk, Madeleine Hellman, Carlos Ladeira
Objectives: To investigate the relationship between clinical outcome and the types of end range procedures used to achieve centralization in a sample of patients with low back pain (LBP) and/or peripheral symptoms. Methods: Small sample retrospective analysis of an observational cohort. Patients with LBP who centralized during initial visit at two physical therapy clinics were recruited to participate. The types of end range procedures used to achieve centralization were documented during each office visit and a chart review was performed after 4 weeks...
February 2018: Journal of Manual & Manipulative Therapy
Guillaume Christe, Toby Hall
Background: Thoracic disc herniations are rare and difficult to diagnose. Myelopathy is a potential consequence that can lead to irreversible neurological impairment if not treated appropriately. It is incumbent on all clinicians who see patients with low back pain (LBP) to be aware of such pathologies. This case describes a screening process in the detection of a rare serious spinal pathology and discusses the use of red flags and central nervous system signs and symptoms in the decision leading to immediate referral...
February 2018: Journal of Manual & Manipulative Therapy
Jo Nijs, Olivier Mairesse, Daniel Neu, Laurence Leysen, Lieven Danneels, Barbara Cagnie, Mira Meeus, Maarten Moens, Kelly Ickmans, Dorien Goubert
Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain...
February 7, 2018: Physical Therapy
Seunghwan Kim, Jung Hyun Kim, You Lim Kim, Suk Min Lee
[Purpose] This study investigated the relationship between pain intensity, lumber disability, and psychological factors in patients with low back pain. [Subjects and Methods] A total of 166 outpatients (116 female, 50 male) with chronic low back pain presenting for physical therapy participated in this study. Patients were divided into two groups: those with low back pain alone and those with both low back pain and radicular pain. Pain intensity and lumbar disability were measured using a visual analogue scale and the Roland-Morris Disability Questionnaire...
January 2018: Journal of Physical Therapy Science
Dong-Kyu Lee, Yong-Nam Kim, Chi-Bok Park, Mi-Sook Park
[Purpose] This study aimed to determine the effect of a Flexi-Bar exercise program with vibration stimulation on pain and dysfunction in patients with low back pain. [Subjects and Methods] This study included 30 patients with low back pain. The participants were divided into a control (n=15) group and an experimental group (n=15). General physical therapy was used in both groups. A Flexi-Bar exercise program with vibration stimulation was used in the experimental group. The Visual Analog Scale was used to measure pain severity...
January 2018: Journal of Physical Therapy Science
Francisco Alburquerque-Sendín, Pascal Madeleine, César Fernández-de-Las-Peñas, Paula Rezende Camargo, Tania Fátima Salvini
Mechanical hyperalgesia defined as decreased pressure pain thresholds (PPTs) is commonly associated with pain. In this narrative review, we report the current state of the art within topographical pressure sensitivity maps. Such maps are based on multiple PPT assessments. The PPTs are assessed by an a priori defined grid with special focus on both spatial and temporal summation issues. The grid covers the muscle or the body region of interest using absolute or relative values determined from anatomical landmarks or anthropometric values...
2018: Journal of Pain Research
Masakazu Minetama, Mamoru Kawakami, Masafumi Nakagawa, Yuyu Ishimoto, Keiji Nagata, Daisuke Fukui, Tadashi Sumiya, Tomoko Kitagawa, Takahiro Miyake, Yoshio Yamamoto, Nana Sakon, Toshiko Matsuoka, Yukihiro Nakagawa
BACKGROUND: The efficacy of physical therapy for patients with lumbar spinal stenosis (LSS) has been reported only for the short term, and few reports have compared outcomes of surgical treatment with nonsurgical treatment after physical therapy. The purpose of this study was to assess 2-year outcomes of LSS patients treated with surgery or under follow-up observation after physical therapy for 6 weeks. METHODS: Patients presenting with neurogenic claudication, radiologically-confirmed central LSS affecting both legs and refractory symptoms to pharmacotherapy of more than 3 months were enrolled...
January 29, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Shirley Musich, Shaohung S Wang, Luke B Slindee, Karen Keown, Kevin Hawkins, Charlotte S Yeh
Objective: To examine the prevalence of musculoskeletal back pain among older adults stratified by pain medication intensity to 1) review treatment patterns and 2) consider targeted back pain prevention interventions. Methods: A random sample of older adults age 64 years and older was utilized to identify new and recurring back pain. Prescription pain medications from drug claims were used to stratify to five unique intensity levels. The characteristics of each level were determined using regression models...
January 31, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Po-Chang Hsu, Shyi-Jou Chen
RATIONALE: The serum and urine-free light chain (sFLC/uFLC) ratios of kappa (κ) to lambda (λ) serve as biomarkers for plasma cell disorders, especially multiple myeloma. However, to our best knowledge, the ratios have not been appropriately assessed for acute transverse myelitis (ATM). PATIENT CONCERNS: We present a 12-year-old boy who had sudden onset low back pain following paralysis of his 4 extremities and disturbance consciousness. Magnetic resonance imaging (MRI) of the brain and spine indicated diffuse hyperintensity in T2-weighted images from the cervical spinal cord to the conus medullaris...
December 2017: Medicine (Baltimore)
Ian D Coulter, Cindy Crawford, Eric L Hurwitz, Howard Vernon, Raheleh Khorsan, Marika Suttorp Booth, Patricia M Herman
BACKGROUND CONTEXT: Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However, questions remain about their efficacy, dosing, safety, as well as how these approaches compare to other therapies. PURPOSE: To determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain. STUDY DESIGN/SETTING: A systematic literature review and meta-analysis...
January 22, 2018: Spine Journal: Official Journal of the North American Spine Society
Vincent Dewitte, Robby De Pauw, Kayleigh De Meulemeester, Wim Peersman, Lieven Danneels, Katie Bouche, Arne Roets, Barbara Cagnie
BACKGROUND: Nonspecific low back pain (NSLBP) is a common problem. Attempts have been made to classify NSLBP patients into homogenous subgroups. Classification systems based on identifying the underlying mechanism(s) driving the disorder are clinically useful to guide specific interventions. OBJECTIVE: To establish consensus among experts regarding clinical criteria suggestive of a dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns (DPs) in NSLBP patients...
January 8, 2018: Musculoskeletal Science & Practice
Crystian B Oliveira, Márcia R Franco, Chris G Maher, Anne Tiedemann, Fernanda G Silva, Tatiana M Damato, Michael K Nicholas, Diego G D Christofaro, Rafael Z Pinto
BACKGROUND: Physical activity plays an important role in the management of chronic low back pain (LBP). Engaging in an active lifestyle is associated with a better prognosis. Nevertheless, there is evidence to suggest that patients with chronic LBP are less likely to meet recommended physical activity levels. Furthermore, while exercise therapy has been endorsed by recent clinical practice guidelines, evidence from systematic reviews suggests that its effect on pain and disability are at best moderate and not sustained over time...
January 15, 2018: Trials
Mathew E DiMond
Objective: The purpose of this case report was to describe the chiropractic management of thoracolumbar syndrome using multimodal therapies. Clinical Features: A 33-year-old woman with 3 weeks of back pain presented to a chiropractic clinic. Nerve tension tests and local tenderness were present in a pattern described by Maigne, and she was diagnosed with thoracolumbar syndrome (Maigne syndrome) at her initial visit. Intervention and Outcomes: The Oswestry Disability Index for low back pain (62%), STarT low back screen tool for clinical outcomes (6 points total, with a 2-point subscale), numeric pain rating scale (6/10 constant, 10/10 with provocation), and test-retest exercise audits were outcome measures...
December 2017: Journal of Chiropractic Medicine
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
Wayne Brewer, Brian T Swanson, Toni S Roddey, Habeeblai Adewale, Caleb Ashmore, Jennifer Frerich, Cory Perrin, Alexis Ortiz
BACKGROUND: A pilot study was conducted to quantify the effect size of changes in physical activity after of one session of physical therapy for individuals with chronic low back pain and to determine factors that predict daily sedentary activity time. METHODS: Fourteen subjects with at least 3 days of physical activity accelerometer data were analyzed before and after one session of physical therapy. Data was analyzed using 1-tailed, paired t-tests with level of significance set at 0...
December 6, 2017: BMC Research Notes
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