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pain low back guideline review

David A Provenzano, Khalid M Kamal, Vincent Giannetti
BACKGROUND: The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surrounding the pain management practices of PCPs. OBJECTIVE: The purpose of this study is to assess the knowledge and practice of PCPs in management of chronic pain...
November 2018: Pain Physician
Jaya Sanapati, Laxmaiah Manchikanti, Sairam Atluri, Sheldon Jordan, Sheri L Albers, Miguel A Pappolla, Alan D Kaye, Kenneth D Candido, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: 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. OBJECTIVE: To assess the effectiveness of MSCs or PRP injections in the treatment of low back and lower extremity pain. STUDY DESIGN: A systematic review and metaanalysis of the effectiveness of PRP and MSCs injections in managing low back and lower extremity pain...
November 2018: Pain Physician
William Omar Contreras Lopez, Paula Alejandra Navarro, Marcos David Vargas, Eduardo Alape, Paul Anthony Camacho Lopez
OBJECTIVE: Compare pulsed radiofrequency treatment (PRF) with continuous radiofrequency treatment (CRF) to improve pain, functionality, and safety profile in patients with facet joint CLBP. METHODS: A systematic and critical review of recent literature was conducted in accordance with the PRISMA guidelines. The sources of the data were PubMed, Embase, Cochrane, Clinical Trials, and Lilacs. The MeSH terms were: "low back pain," "zygapophyseal joint" and "pulsed radiofrequency treatment...
November 4, 2018: World Neurosurgery
Shanthi Ramanathan, Peter Hibbert, Louise Wiles, Christopher G Maher, William Runciman
BACKGROUND: Although "non-specific" in 90% of cases, low back pain (LBP) is often treated as an independent entity, even though comorbidities are commonly associated with it. There is evidence that some LBP may be related to chronic conditions or be a symptom of poor health. The purpose of this study was to clarify the extent of comorbidities amongst a cohort of Australian adults with LBP and examine if having concurrent conditions has any association with appropriateness of care for LBP...
November 6, 2018: BMC Musculoskeletal Disorders
Timothy R Deer, Jay S Grider, Jason E Pope, Steven Falowski, Tim J Lamer, Aaron Calodney, David A Provenzano, Dawood Sayed, Eric Lee, Sayed E Wahezi, Chong Kim, Corey Hunter, Mayank Gupta, Rasmin Benyamin, Bohdan Chopko, Didier Demesmin, Sudhir Diwan, Christopher Gharibo, Leo Kapural, David Kloth, Brian D Klagges, Michael Harned, Tom Simopoulos, Tory McJunkin, Jonathan D Carlson, Richard W Rosenquist, Timothy R Lubenow, Nagy Mekhail
BACKGROUND: Lumbar spinal stenosis (LSS) can lead to compression of neural elements and manifest as low back and leg pain. LSS has traditionally been treated with a variety of conservative (pain medications, physical therapy, epidural spinal injections) and invasive (surgical decompression) options. Recently, several minimally invasive procedures have expanded the treatment options. METHODS: The Lumbar Spinal Stenosis Consensus Group convened to evaluate the peer-reviewed literature as the basis for making Minimally Invasive Spine Treatment (MIST) recommendations...
October 27, 2018: Pain Practice: the Official Journal of World Institute of Pain
Ulrike H Mitchell, Jennifer Hurrell
BACKGROUND: Between 2005 and 2015 significant changes in the clinical decision making paradigm for the treatment of spinal instability occurred. This was largely motivated by a clinical prediction rule (CPR) derivation study that was developed to specifically identify patients with low back pain who are more likely to respond positively to lumbar stabilization exercises. OBJECTIVE: This is a narrative literature review on the recent advances physiotherapy has made in the treatment of clinical spinal instability...
October 1, 2018: Journal of Back and Musculoskeletal Rehabilitation
Patricia C S Parreira, Christopher G Maher, Adrian C Traeger, Mark J Hancock, Aron Downie, Bart W Koes, Manuela L Ferreira
OBJECTIVES: (1) Describe the evolution of guideline-endorsed red flags for fracture in patients presenting with low back pain; (2) evaluate agreement between guidelines; and (3) evaluate the extent to which recommendations are accompanied by information on diagnostic accuracy of endorsed red flags. DESIGN: Systematic review. DATA SOURCES: MEDLINE and PubMed, PEDro, CINAHL and EMBASE electronic databases. We also searched in guideline databases, including the National Guideline Clearinghouse and Canadian Medical Association Infobase ...
October 18, 2018: British Journal of Sports Medicine
Fabio Martino Doniselli, Moreno Zanardo, Luigi Manfrè, Giacomo Davide Edoardo Papini, Alex Rovira, Francesco Sardanelli, Luca Maria Sconfienza, Estanislao Arana
PURPOSE: To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations. METHODS: No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009...
November 2018: European Spine Journal
Dinesh Rao, Gaelyn Scuderi, Chris Scuderi, Reetu Grewal, Sukhwinder Js Sandhu
Lower back pain (LBP) is one of the most common chief complaints encountered in primary care. Advanced imaging studies, including computerized tomography (CT) and magnetic resonance imaging (MRI), are frequently ordered in the setting of LBP. Structural abnormalities are commonly identified by CT and MRI in patients complaining of low back pain, however, these findings are also found in asymptomatic patients. In the past decade, multiple guidelines have been published to help providers identify patients in whom the use of advanced imaging is appropriate...
2018: Journal of Clinical Imaging Science
Scott Haldeman, Claire D Johnson, Roger Chou, Margareta Nordin, Pierre Côté, Eric L Hurwitz, Bart N Green, Christine Cedraschi, Emre Acaroğlu, Deborah Kopansky-Giles, Arthur Ameis, Afua Adjei-Kwayisi, Selim Ayhan, Fiona Blyth, David Borenstein, O'Dane Brady, Peter Brooks, Connie Camilleri, Juan M Castellote, Michael B Clay, Fereydoun Davatchi, Robert Dunn, Christine Goertz, Erin A Griffith, Maria Hondras, Edward J Kane, Nadège Lemeunier, John Mayer, Tiro Mmopelwa, Michael Modic, Jean Moss, Rajani Mullerpatan, Elijah Muteti, Lillian Mwaniki, Madeleine Ngandeu-Singwe, Geoff Outerbridge, Kristi Randhawa, Heather Shearer, Erkin Sönmez, Carlos Torres, Paola Torres, Leslie Verville, Adriaan Vlok, William Watters, Chung Chek Wong, Hainan Yu
PURPOSE: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. METHODS: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate...
September 2018: European Spine Journal
Saurab Sharma, Mark P Jensen, G Lorimer Moseley, J Haxby Abbott
INTRODUCTION: Low back pain (LBP) is the leading cause of years lived with disability in Nepal and elsewhere. Management of LBP that is evidence-based, easily accessible, cost-effective and culturally appropriate is desirable. The primary aim of this feasibility study is to determine if it is feasible to conduct a full randomised clinical trial evaluating the effectiveness of pain education as an intervention for individuals with LBP in Nepal, relative to guideline-based physiotherapy treatment...
August 10, 2018: BMJ Open
Ferran Cuenca-Martínez, Sara Cortés-Amador, Gemma Victoria Espí-López
INTRODUCTION: Chronic low back pain is a pathological process that compromises the functionality and quality of life worldwide. The objective of the study was to evaluate the effectiveness of classical physiotherapy in the management of non-specific chronic low back pain. METHODS: A literature search in English electronic databases was performed from November to December of 2015. Only those studies addressing chronic non-specific low back pain by manual therapy and different types of exercises methods were included, and those, which combined acute or subacute pain with systematic reviews and clinical practice guidelines, were excluded...
2018: Physical Therapy Research
Daniel Roenz, Jake Broccolo, Steven Brust, Jordan Billings, Alexander Perrott, Jeremy Hagadorn, Chad Cook, Joshua Cleland
Objective: The purpose of this systematic review and meta-analysis was to examine the impact of pragmatic versus prescriptive study designs on the outcomes of low back and neck pain when using mobilization or manipulation techniques. Methods: This study design was a systematic review and meta-analysis, which was performed according to the PRISMA guidelines. A search of MEDLINE and CINAHL complete databases was performed. Article titles and abstracts were reviewed to identify studies comparing mobilization and manipulation in low back or neck pain that met eligibility criteria...
July 2018: Journal of Manual & Manipulative Therapy
Louisa Chou, Tom A Ranger, Waruna Peiris, Flavia M Cicuttini, Donna M Urquhart, Andrew M Briggs, Anita E Wluka
OBJECTIVES: Allied health and complementary and alternative medicines (CAM) are therapeutic therapies commonly accessed by consumers to manage low back pain (LBP). We aimed to identify the literature regarding patients' perceived needs for physiotherapy, chiropractic therapy and CAM for the management of LBP. METHODS: A systematic scoping review of MEDLINE, EMBASE, CINAHL and PsycINFO (1990-2016) was conducted to identify studies examining patients' perceived needs for allied health and CAM for LBP...
October 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Crystian B Oliveira, Chris G Maher, Rafael Z Pinto, Adrian C Traeger, Chung-Wei Christine Lin, Jean-François Chenot, Maurits van Tulder, Bart W Koes
OBJECTIVE: The aim of this study was to provide an overview of the recommendations regarding the diagnosis and treatment contained in current clinical practice guidelines for patients with non-specific low back pain in primary care. We also aimed to examine how recommendations have changed since our last overview in 2010. METHOD: The searches for clinical practice guidelines were performed for the period from 2008 to 2017 in electronic databases. Guidelines including information regarding either the diagnosis or treatment of non-specific low back pain, and targeted at a multidisciplinary audience in the primary care setting, were considered eligible...
November 2018: European Spine Journal
Jetan H Badhiwala, Farshad Nassiri, Christopher D Witiw, Alireza Mansouri, Naif Alotaibi, Matthew Eagles, Saleh A Almenawer, Leodante da Costa, Jefferson R Wilson, Michael G Fehlings
STUDY DESIGN: Bibliometric analysis. OBJECTIVE: To identify, and summarize the key findings of, the top 100 most highly cited works published in spinal disorder topic-specific journals. SUMMARY OF BACKGROUND DATA: There is an abundance of published articles pertaining to spine surgery and spinal disorders. The number of citations a work receives provides a useful measure of its scientific impact. An understanding of the most cited works in spine surgery can identify literature that surgeons and researchers should be familiar with, point to the most active areas of research, inform the design of educational curricula, and help guide future research efforts...
June 8, 2018: Spine
Thomas S W Park, Andy Kuo, Maree T Smith
Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population...
May 12, 2018: Inflammopharmacology
Hazel J Jenkins, Aron S Downie, Chris G Maher, Niamh A Moloney, John S Magnussen, Mark J Hancock
BACKGROUND CONTEXT: The problem of imaging patients with low back pain (LBP) when it is not indicated is well recognized. The converse is also possible, although rarely considered. The extent of these two problems is presently unclear. PURPOSE: This study aimed to estimate how commonly overuse, and also underuse, of imaging occurs in the management of LBP, and how appropriate use of imaging is assessed. DESIGN: This is a systematic review and meta-analysis...
May 3, 2018: Spine Journal: Official Journal of the North American Spine Society
Janessa M Graves, Deborah Fulton-Kehoe, Jeffrey G Jarvik, Gary M Franklin
BACKGROUND: Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES: To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. RESEARCH DESIGN: Interrupted time series...
June 2018: Medical Care
Matheus Almeida, Bruno Saragiotto, Bethan Richards, Chris G Maher
Research in the past decade supports some major changes to the primary care management of non-specific low back pain (LBP). The present article summarises recommendations from recently published United Kingdom, Danish, Belgian and United States guidelines to alert readers to the important changes in recommendations for management, and the recommendations from previous guidelines that remain unchanged. Main recommendations: Use a clinical assessment to triage patients with LBP. Further diagnostic workup is only required for the small number of patients with suspected serious pathology...
April 2, 2018: Medical Journal of Australia
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