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Lumbar chronic pain

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https://www.readbyqxmd.com/read/28440001/treating-low-back-pain-with-combined-cerebral-and-peripheral-electrical-stimulation-a-randomized-double-blind-factorial-clinical-trial
#1
F A Hazime, A F Baptista, D G de Freitas, R L Monteiro, R L Maretto, R H Hasue, S M A João
BACKGROUND: Recent evidence suggests that chronic low back pain is associated with plastic changes in the brain that can be modified by neuromodulation strategies. This study investigated the efficacy of transcranial direct current stimulation (tDCS) combined simultaneously with peripheral electrical stimulation (PES) for pain relief, disability and global perception in patients with chronic low back pain (CLBP). METHODS: Ninety-two patients with CLBP were randomized to receive 12 sessions on nonconsecutive days of anodal tDCS (primary motor cortex, M1), 100 Hz sensory PES (lumbar spine), tDCS + PES or sham tDCS + PES...
April 25, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28437223/exercise-and-peripheral-nerve-grafts-as-a-strategy-to-promote-regeneration-after-acute-or-chronic-spinal-cord-injury
#2
Catherine C Theisen, Rahul Sachdeva, Scarlett Austin, Danielle Kulich, Victoria Kranz, John D Houle
Therapeutic interventions after spinal cord injury (SCI) routinely are designed to address multiple aspects of the primary and/or secondary damage that occurs. Exercise has a demonstrated efficacy for post-SCI complications such as cardiovascular dysfunction, neuropathic pain, and chronic inflammation, yet there is little understanding of the mechanisms by which improvements might result from this non-invasive approach. Here we review several of our observations of molecular and cellular changes within the injured spinal cord following acute or delayed exercise regimens that illustrate the potential for positive effects on neuroprotection and rehabilitation...
April 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28435906/low-back-pain-in-older-adults-risk-factors-management-options-and-future-directions
#3
REVIEW
Arnold Yl Wong, Jaro Karppinen, Dino Samartzis
Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28435318/prevalence-characteristics-and-burden-of-failed-back-surgery-syndrome-the-influence-of-various-residual-symptoms-on-patient-satisfaction-and-quality-of-life-as-assessed-by-a-nationwide-internet-survey-in-japan
#4
Shinsuke Inoue, Mitsuhiro Kamiya, Makoto Nishihara, Young-Chang P Arai, Tatsunori Ikemoto, Takahiro Ushida
We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8-22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28430671/elevated-production-of-nociceptive-cc-chemokines-and-se-selectin-in-patients-with-low-back-pain-and-the-effects-of-spinal-manipulation-a-non-randomized-clinical-trial
#5
Julita A Teodorczyk-Injeyan, Marion McGregor, John J Triano, H Stephen Injeyan
BACKGROUND: The involvement of inflammatory components in the pathophysiology of low back pain is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. PURPOSE: To determine the involvement of inflammation-associated chemokines (CC series) in the pathogenesis of non-specific low back pain and to evaluate the effect of SMT on that process. METHODS: Patients presenting with non-radicular, non-specific low back pain (minimum pain score 3 on 10 point visual analogue scale, VAS) were recruited according to stringent inclusion criteria...
April 19, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#6
Katherine J Simson, Clint T Miller, Jon Ford, Andrew Hahne, Luana Main, Timo Rantalainen, Wei-Peng Teo, Megan Teychenne, David Connell, Guy Trudel, Guoyan Zheng, Gary Thickbroom, Daniel L Belavy
BACKGROUND: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain...
April 20, 2017: Trials
https://www.readbyqxmd.com/read/28422871/ultrasound-versus-fluoroscopy-guided-medial-branch-block-for-the-treatment-of-lower-lumbar-facet-joint-pain-a-retrospective-comparative-study
#7
Seung Hoon Han, Ki Deok Park, Kyoung Rai Cho, Yongbum Park
The aim of this study was to compare the mid-term effects and benefits of ultrasound (US)-guided and fluoroscopy (FL)-guided medial branch blocks (MBBs) for chronic lower lumbar facet joint pain through pain relief, functional improvement, and injection efficiency evaluation.Patients with chronic lumbar facet joint pain who received US (n = 68) or FL-guided MBBs (n = 78) were included in this retrospective study. All procedures were performed under FL or US guidance. Complication frequency, therapeutic effects, functional improvement, and the injection efficiency of MBBs were compared at 1, 3, and 6 months after the last injection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28415980/the-effects-of-bending-speed-on-the-lumbo-pelvic-kinematics-and-movement-pattern-during-forward-bending-in-people-with-and-without-low-back-pain
#8
Sharon M H Tsang, Grace P Y Szeto, Linda M K Li, Dim C M Wong, Millie M P Yip, Raymond Y W Lee
BACKGROUND: Impaired lumbo-pelvic movement in people with low back pain during bending task has been reported previously. However, the regional mobility and the pattern of the lumbo-pelvic movement were found to vary across studies. The inconsistency of the findings may partly be related to variations in the speed at which the task was executed. This study examined the effects of bending speeds on the kinematics and the coordination lumbo-pelvic movement during forward bending, and to compare the performance of individuals with and without low back pain...
April 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28413428/transcriptomic-evidence-of-a-para-inflammatory-state-in-the-middle-aged-lumbar-spinal-cord
#9
William Galbavy, Yong Lu, Martin Kaczocha, Michelino Puopolo, Lixin Liu, Mario J Rebecchi
BACKGROUND: We have previously reported elevated expression of multiple pro-inflammatory markers in the lumbar spinal cord (LSC) of middle-aged male rats compared to young adults suggesting a para-inflammatory state develops in the LSC by middle age, a time that in humans is associated with the greatest pain prevalence and persistence. The goal of the current study was to examine the transcriptome-wide gene expression differences between young and middle aged LSC. METHODS: Young (3 month) and middle-aged (17 month) naïve Fisher 344 rats (n = 5 per group) were euthanized, perfused with heparinized saline, and the LSC were removed...
2017: Immunity & Ageing: I & A
https://www.readbyqxmd.com/read/28413117/structure-specific-movement-patterns-in-patients-with-chronic-low-back-dysfunction-using-lumbar-combined-movement-examination
#10
Aubrey P Monie, Roger I Price, Christopher R P Lind, Kevin P Singer
OBJECTIVE: A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. METHODS: Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention...
April 13, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28402092/ultrasound-determined-landmarks-decreases-pressure-pain-at-epidural-insertion-site-in-immediate-postpartum-period
#11
Denise Wilkes, Caroline Martinello, Felipe A Medeiros, Rovnat Babazade, Erin Hurwitz, Naveed Khanjee, Prashanth S Iyer, Paul Leary, Rakesh B Vadhera
BACKGROUND: Women have blamed epidurals for their post-partum back pain for decades. Survey-based studies have shown similar incidence of chronic back pain between women who delivered with epidurals compared to those who did not. However, epidural insertion site pain has yet to be evaluated by a quantitative measure: pressure pain threshold (PPT). Algometer measured PPT has been shown to be accurate and reproducible in acute, chronic, and post-operative pain studies. This study determines the effect of ultrasound-based landmarks on the PPT at the epidural insertion site in the postpartum period...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28379464/filum-terminale-needle-placement-during-caudal-epidural-steroid-injection
#12
Ryan R Ramsook, David Spinner, Rajiv R Doshi
Objective. : Caudal epidural steroid injections (ESIs) are commonly used to treat lumbar radicular pain. Touhy needles are placed under live fluoroscopic guidance to ensure epidural administration of medication. This is a case report of direct needle and catheter placements into and through the filum terminale during a caudal approach to the epidural space. Design. : Single case report. Setting. : Beth Israel Deaconess Medical Center...
March 30, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28377243/hybrid-bone-spect-ct-imaging-in-evaluation-of-chronic-low-back-pain-correlation-with-modic-changes-and-degenerative-disc-disease
#13
Vittorio M Russo, Ranju T Dhawan, Nishanth Dharmarajah, I Baudracco, Antonio I Lazzarino, Adrian T Casey
BACKGROUND CONTEXT: Multiple radiological modalities are used in the evaluation of patients with low back pain (LBP). Only limited evidence currently exists to support the use of Bone HDP (hydroxydiphosphonate) SPECT/CT (Single Photon Emission Computed Tomography) in patients with Modic changes (MC) and degenerative disc disease (DDD). PURPOSE: The aim of this study was to assess the value of the hybrid Bone SPECT/CT imaging in patients with chronic low back pain...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28376754/fat-in-the-lumbar-multifidus-muscles-predictive-value-and-change-following-disc-prosthesis-surgery-and-multidisciplinary-rehabilitation-in-patients-with-chronic-low-back-pain-and-degenerative-disc-2-year-follow-up-of-a-randomized-trial
#14
Kjersti Storheim, Linda Berg, Christian Hellum, Øivind Gjertsen, Gesche Neckelmann, Ansgar Espeland, Anne Keller
BACKGROUND: Evidence is lacking on whether fat infiltration in the multifidus muscles affects outcomes after total disc replacement (TDR) surgery and if it develops after surgery. The aims of this study were 1) to investigate whether pre-treatment multifidus muscle fat infiltration predicts outcome 2 years after treatment with TDR surgery or multidisciplinary rehabilitation, and 2) to compare changes in multifidus muscle fat infiltration from pre-treatment to 2-year follow-up between the two treatment groups...
April 4, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28371249/osteoid-osteoma-benign-osteoblastic-tumor-of-the-lumbar-l4-transverse-process-associated-with-radicular-pain-a-case-report
#15
Carlos L Nebreda, Ricardo Vallejo, Victor Mayoral-Rojals, Antonio Ojeda
Osteoid osteomas of the spine are benign bone tumors typically presenting with progressive pain without neurological deficit. This report presents a case of an osteoid osteoma in the lumbar spine associated with radicular pain. The patient, a young male athlete, presented with severe chronic nightly left low back pain radiated to the ipsilateral lower extremity who failed to respond to physical therapy and analgesic medications. Initial radiologic examination was reported as normal, but closer inspection of the T1- and T2-weighted magnetic resonance image as well as technetium-99m total body bone scan and a computed tomography scan revealed a bony lesion in the left transverse process of the L4 vertebra consistent with the diagnosis of osteoid osteoma...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28371046/does-age-impact-on-expectations-and-concerns-of-patients-attending-a-chronic-pain-clinic
#16
Margaret McLoughlin, Ather Imran, Ailish Hannigan, Dominic Harmon
BACKGROUND: Recognizing expectations and concerns of patients leads to more specialized management plans and greater adherence to treatment, and improves outcomes. Little is known about how age impacts on expectations or concerns regarding pain in patients attending a chronic pain clinic. METHODS: We prospectively assessed the expectations and concerns of 100 adult patients at their first visit to a pain clinic. Patients reported their expectations and concerns for the clinic visit using a self-completed questionnaire...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28368981/evidence-gaps-in-the-use-of-spinal-cord-stimulation-for-treating-chronic-spine-conditions
#17
David A Provenzano, Kasra Amirdelfan, Leonardo Kapural, B Todd Sitzman
STUDY DESIGN: A review of literature. OBJECTIVE: To define and explore the current evidence gaps in the use of spinal cord stimulation for treating chronic spine conditions. SUMMARY OF BACKGROUND DATA: Although, over the last 40 years spinal cord stimulation therapy has undergone significant technological advancements, evidence gaps still exist. METHODS: A Literature review was conducted to define current evidence gaps for the use of spinal cord stimulation...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28367388/delayed-recognition-of-thoracic-and-lumbar-vertebral-compression-fractures-in-minor-accident-cases
#18
Jesse Hatgis, Michelle Granville, Robert E Jacobson
Osteoporotic vertebral compression fractures (VCFs) in the elderly are commonly diagnosed after a minor fall or trauma; however, the majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall. Although accidents are a known cause of VCFs, these fractures are too often undiagnosed. In reviewing a group of patients seen after minor falls or automobile accidents who were complaining of general spine pain, we found a smaller subgroup with previously undiagnosed VCFs...
February 23, 2017: Curēus
https://www.readbyqxmd.com/read/28363630/erratum-to-archer-kr-devin-cj-vanston-sw-koyama-t-phillips-se-mathis-sl-george-sz-mcgirt-mj-spengler-dm-aaronson-os-cheng-js-wegener-st-cognitive-behavioral-based-physical-therapy-for-patients-with-chronic-pain-undergoing-lumbar-spine-surgery-a-randomized-controlled
#19
https://www.readbyqxmd.com/read/28358780/the-cure-that-lies-within-the-mind-body-connection-in-orthopaedics
#20
Erin Sullivan, Jeremy Hudson
The mind and the body are clearly intertwined in ways that are only now being discovered. In the orthopaedic world, injuries and diseases are often classified and described in a very organized, discrete fashion-The radius is fractured, the ACL or meniscus or rotator cuff is torn, the ankle is sprained, and/or the lumbar spine has a disc herniation. Although it is, in many ways, almost comforting to think about injuries or orthopaedic issues in this manner, what about the many patients who fail to fall into this classification? What about the thousands of patients with severe unexplained chronic pain or patients who just are not improving with the typical treatment algorithm...
March 2017: Orthopaedic Nursing
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