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Mechanical back pain

R Whittle, G Mansell, P Jellema, D van der Windt
BACKGROUND: Many randomized controlled trials (RCTs) of psychosocial interventions for low back pain (LBP) have been found to have only small effects on disability outcomes. Investigations of the specific mechanisms that may lead to an improvement in outcome have therefore been called for. METHODS: We present an application of the causal inference approach to mediation analysis using the example of a cluster RCT in a primary care population with (sub)acute LBP randomized to either usual GP care (n = 171) or a minimal psychosocial intervention (n = 143)...
October 14, 2016: European Journal of Pain: EJP
Dhungana Hemanta, Xiao-Xing Jiang, Zhen-Zhou Feng, Zi-Xian Chen, Yuan-Wu Cao
Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging, which has been found to be a contributing factor for low back pain and might cause radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis, and herniations. Its etiology is complex and multifactorial. Although genetics influence more dominant, the occupational and mechanical influences still persist as a major risk factor. This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational, lifestyle factors, and genetic polymorphisms...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Jamileh Moghimi, Ali Asghar Rezaei, Raheb Ghorbani, Mohammad Reza Razavi, Daryoush Pahlevan
In the current study, the overall prevalence and the main underlying etiologies of inflammatory low back pain (ILBP) were determined, and the effectiveness of treatment with sulfasalazine was investigated in patients with inflammatory versus mechanical low back pain (LBP). In a prospective study conducted from July 2013 until August 2015, 1,779 consecutive patients within the age range of 18-50 years with a primary complaint of LBP referring to the rheumatology clinics were included. The patients were classified into two distinct groups: those suffering from ILBP (n=118) and those having mechanical LBP (n=1,661)...
2016: Drug Design, Development and Therapy
Rebecca Wilson, Richard Kendall
Low back pain and obesity are both rising epidemics. This manuscript will examine global trends in obesity, contributory lifestyle and societal factors, and morbidity and mortality associated with cardiovascular disease. Using this background information, the article will explore the complex physiological process of atherosclerosis and association between impaired lumbar perfusion and low back pain. It will also give specific guidance on exercise and nutrition to help treat these potential underlying and contributory mechanisms of spine pathology...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Tae Hyun Kim, Jun Jae Shin, Woo Yong Lee
BACKGROUND: Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural catheter is needed. Until now, only three cases related to sheared Racz neuroplasty catheters have been reported...
October 6, 2016: Journal of Medical Case Reports
Chenglin Sang, Xuecheng Cao, Fangjing Chen, Xuekang Yang, Yongxian Zhang
Objective. Nucleus pulposus (NP) and annulus fibrosus (AF) are two main components of intervertebral disc (IVD). We aimed to figure out whether NP and AF also contain stem cells and whether these stem cells share common properties with chondrocytes and/or fibroblasts in their phenotypes or whether they are completely different types of cells with different characteristics. Design. The disk cells were isolated from AF and NP tissues of the same lumbar spine of the rabbits. The properties of these disk cells were characterized by their morphology, population doubling time (PDT), stem cell marker expression, and multidifferentiation potential using tissue culture techniques, immunocytochemistry, and RT-PCR...
2016: Stem Cells International
Akihiro Nakamura, Y Raja Rampersaud, Anirudh Sharma, Stephen J Lewis, Brian Wu, Poulami Datta, Kala Sundararajan, Helal Endisha, Evgeny Rossomacha, Jason S Rockel, Igor Jurisica, Mohit Kapoor
Osteoarthritis (OA) of spine (facet joints [FJs]) is one of the major causes of severe low back pain and disability worldwide. The degeneration of facet cartilage is a hallmark of FJ OA. However, endogenous mechanisms that initiate degeneration of facet cartilage are unknown, and there are no disease-modifying therapies to stop FJ OA. In this study, we have identified microRNAs (small noncoding RNAs) as mediators of FJ cartilage degeneration. We first established a cohort of patients with varying degrees of facet cartilage degeneration (control group: normal or mild facet cartilage degeneration; FJ OA group: moderate to severe facet cartilage degeneration) and then screened 2,100 miRNAs and identified 2 miRNAs (miR-181a-5p and miR-4454) that were significantly elevated in FJ OA cartilage compared with control facet cartilage...
August 4, 2016: JCI Insight
Chaoqun Yang, Peipei Ding, Qingkai Wang, Long Zhang, Xin Zhang, Jianquan Zhao, Enjie Xu, Na Wang, Jianfeng Chen, Guang Yang, Weiguo Hu, Xuhui Zhou
Ankylosing spondylitis (AS) is a chronic axial spondyloarthritis (SpA) resulting in back pain and progressive spinal ankyloses. Currently, there are no effective therapeutics targeting AS largely due to elusive pathogenesis mechanisms, even as potential candidates such as HLA-B27 autoantigen have been identified. Herein, we employed a proteoglycan (PG)-induced AS mouse model together with clinical specimens, and found that the complement system was substantially activated in the spinal bone marrow, accompanied by a remarkable proportion alteration of neutrophils and macrophage in bone marrow and spleen, and by the significant increase of TGF-β1 in serum...
October 4, 2016: Scientific Reports
Joanna Shi-En Chan, Jeremy C Wee, R Ponampalam, Evelyn Wong
BACKGROUND: Injuries in divers resulting purely from impact with the water are uncommon in the published literature. We present a case report of pulmonary contusion in a young diver. CASE REPORT: A young, healthy competitive platform diver landed flat on his back in the water from a dive of 10 meters. He complained of upper back pain and had an episode of hemoptysis after the dive. He was initially observed for 15 hours postinjury, and was discharged when three chest radiographs (CXRs) taken at 1, 7, and 11 hours postinjury did not show significant abnormalities...
September 28, 2016: Journal of Emergency Medicine
Ciara Clancy, Alison Quinn, Fiona Wilson
PURPOSE: Four to fifty percent of patients will develop Failed Back Surgery Syndrome (FBSS) following lumbar spine surgery. Repeated surgeries lead to escalating costs and subsequent decreases in success rate. Much of the research to date has focused on the psychosocial factors associated with FBSS. All factors including physical and pathological aetiologies should be examined. These factors may be independent, co-exist with or predispose patients to the psychological factors associated with FBSS...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
David M Dickerson, Ran Dai, Barbara M Scavone, William McDade
Reports exist of severe upper back pain of unknown etiology after administration of large volumes into the epidural space. We present a case of an otherwise healthy parturient who developed severe upper back and neck pain after receiving only a small volume of epidural medication. Magnetic resonance imaging revealed a congenitally narrowed spinal canal because of short pedicle syndrome. Epidural injectate occupies and compresses a percentage of the spinal canal and its neuronal contents. This may result in pain and epidural intolerance when continued injectate reaches a critical point, a threshold that is lower with shortened pedicles or congenital spinal stenosis...
September 28, 2016: Regional Anesthesia and Pain Medicine
Gauri Tendulkar, Phillip Grau, Patrick Ziegler, Alfred Buck, Alfred Buck, Andreas Badke, Hans-Peter Kaps, Sabrina Ehnert, Andreas K Nussler
Intervertebral disc degeneration and disc herniation is one of the major causes of lower back pain. Depletion of extracellular matrix, culminating in nucleus pulposus (NP) extrusion leads to intervertebral disc destruction. Currently available surgical treatments reduce the pain but do not restore the mechanical functionality of the spine. In order to preserve mechanical features of the spine, total disc or nucleus replacement thus became a wide interest. However, this arthroplasty era is still in an immature state, since none of the existing products have been clinically evaluated...
2016: Journal of Visualized Experiments: JoVE
Luiza F Teixeira, Leani S M Pereira, Silvia L A Silva, João M D Dias, Rosângela C Dias
Background: The attitudes and beliefs that older people have about acute low back pain (LBP) may influence the coping mechanisms and the adoption of treatment strategies in this population. Objective: The aim of this study was to identify the factors associated with the attitudes and beliefs of elderly patients with acute low back pain using the Back Beliefs Questionnaire. Method: This is a cross-sectional study with a subsample of the study "Back Complaints in the Elders" (BACE), composed of 532 older Brazilians of both genders with acute LBP...
September 15, 2016: Brazilian Journal of Physical Therapy
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
W Huang, M Calvo, T Pheby, D L H Bennett, A S C Rice
HIV-associated sensory neuropathy (HIV-SN) is the most frequent manifestation of HIV disease. It often presents with significant neuropathic pain and is associated with previous exposure to neurotoxic nucleoside reverse transcriptase inhibitors. However, HIV-SN prevalence remains high even in resource-rich settings where these drugs are no longer used. Previous evidence suggests that exposure to indinavir, a protease inhibitor commonly used in antiretroviral therapy, may link to elevated HIV-SN risk. Here we investigated whether indinavir treatment was associated with the development of a "dying back" axonal neuropathy and changes in pain-relevant limb withdrawal and thigmotactic behaviours...
September 23, 2016: Pain
Simon Wan, Samantha Borland, Stephen M Richardson, Catherine L R Merry, Alberto Saiani, Julie E Gough
: Cell-based therapies for regeneration of intervertebral discs are regarded to hold promise for degenerative disc disease treatment, a condition that is strongly linked to lower back pain. A de novo self-assembling peptide hydrogel (SAPH), chosen for its biocompatibility, tailorable properties and nanofibrous architecture, was investigated as a cell carrier and scaffold for nucleus pulposus (NP) tissue engineering. Oscillatory rheology determined that the system would likely be deliverable via minimally invasive procedure and mechanical properties could be optimised to match the stiffness of the native human NP...
September 24, 2016: Acta Biomaterialia
Laurent Savalli, Maria Isabel Hernandez Sendin, Florence Ceselin
OBJECTIVE: Evaluation, at one year, of a short duration multidisciplinary educational program for the chronic, short-term low-back pain. MATERIAL/PATIENTS AND METHODS: During the year 2012, 107 patients with chronic low-back pains were included into a therapeutic educational program. This program consisted in explaining exercises to relieve back pain, in giving information about the mechanisms implied in the low-back pain and in inciting the practice of a regular physical activity...
September 2016: Annals of Physical and Rehabilitation Medicine
Jean-Claude Bernard, Karimann Abelin-Genevois, Isabelle Courtois
This is a national retrospective study realized by the Study Group of Scoliosis (GES) with the support of 7 competence centers about the follow up of the spine for patients with Marfan's disease. The sample consists of 167 patients: 99 women and 67 men. It is composed of children and adults and the mean age is 31 years. In this sample, we find 72% of spine deformity (scoliosis and kyphosis): in the literature, 63% for Sponseller and al, (JBJSa 1995), and 56% for Garreau and al, (JBJS, 2006). The discovery of the spine problem is effective of 12,8 years old (ET=4,2; range=1-53)...
September 2016: Annals of Physical and Rehabilitation Medicine
Jérôme Molimard, Rebecca Bonnaire, Reynald Convert, Woo Suck Han, Paul Calmels
OBJECTIVE: Although it is only a part of their therapeutic effect, the mechanical effect of compression or contention medical devices (CCMD) is always claimed by the manufacturers. However, the mechanism between the pressure application zone and the targeted organ is complex. It involves a purely passive mechanical effect and mechanisms related to the tonic postural system. Various strategies can be implemented to show the effectiveness of a mechanical action; among them, biomechanical modeling is a able to consider complex mechanical effects before any clinical trial...
September 2016: Annals of Physical and Rehabilitation Medicine
Joséphine Métréau, Frédéric Brogniart, Claude Grandjean, Bertrand Morineaux
OBJECTIVE: Postural balance is ensured by the involvement of several coping strategies. There is however an alteration of the proprioceptive system with chronic low back pain patients making it vulnerable to any type of disruptive force (endogenous and exogenous) and physiologically compensated by the postural system. The aim of this study is to measure the postural changes during a functional restoration protocol. MATERIAL/PATIENTS AND METHODS: Were included in this study, 8 chronic low back pain patients, seen in consultation before being included in the rehabilitative care unit of the Bourbonne-les-Bains Hospital as part of a functional restoration protocol for 5-6 weeks...
September 2016: Annals of Physical and Rehabilitation Medicine
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