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mechanical low back pain

Silvia Lo Vecchio, Lars J Petersen, Thomas Graven-Nielsen, Sara Finocchietti, Parisa Gazerani, Lars Arendt-Nielsen
Background/aims The ultraviolet B (UVB) inflammatory pain model is often used to induce a steady hyperalgesic area in human skin. UVB causes a well-described erythema, developing maximal response within about 24 h. The aim of the present study was to investigate if cutaneous UVB irradiation can influence both superficial and deep-tissue mechanical pain thresholds in the site of irradiation and in the surrounding area. Methods An area of 3 cm × 4 cm, located on the low back of 16 healthy volunteers, was irradiated by UVB (Medlight, Germany; 3xMED: Minimal Erythema Dose)...
December 29, 2017: Scandinavian Journal of Pain
Johanna Thomtén, Andreas Karlsson
Objectives One in five women under the age of 30 report recurrent genital pain and pain during sexual intercourse. Female genital pain negatively affects sexual and general health, as well as dyadic function and quality of life. Although the current field of research and clinical expertise in general agree upon a biopsychosocial conceptualization, there is still a lack of theoretical models describing the psychosocial mechanisms involved in the development of genital pain. Originally developed to outline the transition from acute to chronic back pain, the fear avoidance (FA) model has lately been proposed as a possible tool in illustrating the mechanisms involved in genital pain...
December 29, 2017: Scandinavian Journal of Pain
Jaap H van Dieën, N Peter Reeves, Greg Kawchuk, Linda van Dillen, Paul W Hodges
Synopsis Motor control exercise has been shown to be effective in the management of low-back pain (LBP), but effect sizes are modest, possibly due to the fact that studies have used a one-size-fits-all approach, whereas literature suggests that patients may differ in presence or type of motor control issues. In this commentary, we address the question whether consideration of such variation in motor control issues might contribute to more personalized motor control exercise for patients with LBP. Such an approach is plausible, since motor control changes may play a role in persistence of pain through effects on tissue loading that may cause nociceptive afference in particular in case of peripheral sensitization...
June 12, 2018: Journal of Orthopaedic and Sports Physical Therapy
Jaap H van Dieën, N Peter Reeves, Greg Kawchuk, Linda van Dillen, Paul W Hodges
Synopsis Patients with low-back pain have been shown to display differences compared to healthy individuals in all aspects of trunk motor control, most often studied as differences in muscle activity and kinematics. However, differences in these aspects of motor control are largely inconsistent. We propose that this may reflect existence of two phenotypes, possibly the two ends of a distribution, one with "tight" control over trunk movement and one with "loose" control. Both may have beneficial effects, with tight control protecting against large tissue strains from uncontrolled movement and loose control protecting against high muscle forces and resulting spinal compression...
June 12, 2018: Journal of Orthopaedic and Sports Physical Therapy
John D Markman, Ralf Baron, Jennifer S Gewandter
Here, we examine the stark contrast between the successes and failures of the clinical development of analgesics for different types of chronic low back pain (CLBP) syndrome over the past three decades. Multiple drugs with differing mechanisms of action have been developed for nonspecific axial-predominant low back syndromes and yet not a single therapy is indicated for any neuropathic low back pain syndrome (e.g., sciatica). Clinician findings have informed the entry criteria for neuropathic low back pain clinical trials, whereas entry criteria of axial CLBP trials have prioritized only patient reports of pain...
June 9, 2018: Drug Discovery Today
Paul Gagnet, Kent Kern, Kyle Andrews, Hossein Elgafy, Nabil Ebraheim
Spondylolysis is a common diagnosis with a high prevalence in children and adolescents complaining of low back pain. It may be caused by either a defect or fracture of the pars interarticularis due to mechanical stress. Depending on the severity of the spondylolysis and symptoms associated it may be treated either conservatively or surgically, both of which have shown significant success. Conservative treatments such as bracing and decreased activity have been shown to be most effective with patients who have early diagnosis and treatment...
June 2018: Journal of Orthopaedics
N A Roussel
Despite the high prevalence of recurrent, constant and/or widespread pain in patients with haemophilia (PwH), there is an immense lack of studies examining the (patho)physiology of pain in this population. This contrasts to the bulk of literature in other pain conditions, such as osteoarthritis, low back pain or rheumatoid arthritis. Understanding the complexity of pain allows to better assess and manage pain. In PwH, the first priority is always to exclude bleeding as a cause of pain. An important next step in pain assessment is the evaluation of the predominant pain mechanism (ie nociceptive, neuropathic pain or altered central pain processing) as the treatment approach will be very different according to the underlying pain mechanism...
May 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Julie M Fritz, Jason A Sharpe, Elizabeth Lane, Doug Santillo, Tom Greene, Gregory Kawchuk
BACKGROUND: Low back pain is a common and costly condition. Spinal manipulative therapy (SMT) is a treatment supported in some guidelines, although most clinical trials examining SMT report small effect sizes. Enhancing the effects of SMT requires an understanding of underlying mechanisms and a systematic approach to leverage understanding of mechanisms to create more effective treatment protocols that are scalable in clinical practice. Prior work has identified effects on spinal stiffness and lumbar multifidus activation as possible mechanisms...
June 4, 2018: Trials
M C Gerra, C Dagostino, S D'Agnelli, L Boggiani, V Rizza, M Marchesini, M Allegri, G Fanelli
Aims The present study aims to identify the underlying mechanisms in the acute to chronic pain transition. Acute pain is a physiological response to an experience of noxious stimuli that can progress to chronic, becoming a disease. The negative consequences as personal suffering, reduction in physical function, maladaptive behaviours, reduction of productivity, make this condition a central and common problem affecting individuals and the society. After an acute damage, pain in some cases persists, being the process attributed to different causes, in particular persistent tissue and neuronal damages, central neuroplastic changes, psychosocial factors...
December 29, 2017: Scandinavian Journal of Pain
Soheila Abbasi, Zahra Rojhani-Shirazi, Esmaeil Shokri, Francisco García-Muro San José
PURPOSE: The aim of this study was to investigate the possible alterations in postural control during upright standing in subjects with non-specific chronic low back pain and the effect of Kinesio taping on the postural control. METHODS: Twenty subjects with non-specific chronic low back pain and twenty healthy subjects participated in this study. The center of pressure excursion was evaluated before the intervention for both groups, and immediately after intervention for the low back pain group...
April 2018: Journal of Bodywork and Movement Therapies
Alexander Real, Chierika Ukogu, Divya Krishnamoorthy, Nicole Zubizarreta, Samuel K Cho, Andrew C Hecht, James C Iatridis
BACKGROUND CONTEXT: Low back pain (LBP) is a common complaint in clinical practice of multifactorial origin. Although obesity has been thought to contribute to LBP primarily by altering the distribution of mechanical loads on the spine, the additional contribution of obesity-related conditions such as diabetes mellitus (DM) to LBP has not been thoroughly examined. PURPOSE: To determine if there is a relationship between DM and LBP that is independent of BMI in a large cohort of adult survey participants...
May 30, 2018: Spine Journal: Official Journal of the North American Spine Society
Sabrina Munir, Maxim B Freidin, Marinko Rade, Juhani Määttä, Gregory Livshits, Frances M K Williams
STUDY DESIGN: Longitudinal study of spine magnetic resonance imaging (MRI) in a large-scale population-based study. OBJECTIVE: To determine the order of appearance of degenerative change in vertebral bodies and intervertebral discs. We also sought to define the influence of endplate defect on low back pain (LBP) and to determine whether there is a genetic influence on endplate defect. SUMMARY OF BACKGROUND DATA: Endplate defect is a magnetic resonance imaging trait, found to be associated with intervertebral disc degeneration...
May 25, 2018: Spine
Vineet S Rolston, Anish V Patel, Thomas J Learch, Dalin Li, Dmitry Karayev, Chadwick Williams, Madhavi L Siddanthi, Stephan R Targan, Michael H Weisman, Dermot P B McGovern
OBJECTIVES: Avascular necrosis (AVN) is associated with significant morbidity potentially causing severe pain and debility; patients with inflammatory bowel disease (IBD) have a higher prevalence of AVN compared with non-IBD populations. The purpose of our study was to determine the prevalence of AVN in our IBD population and to evaluate these subjects for the presence of clinical characteristics associated with AVN on computed tomography (CT) imaging. METHODS: In 1313 IBD patients with abdomen/pelvis CT scans, we identified 27 patients (2...
May 24, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Magali Millecamps, Laura S Stone
Low back pain is associated with both axial discomfort and radiating leg pain. While intervertebral discs are suspected as the source of pain in some individuals, the relationship between disc degeneration and back pain remains controversial. The goals of this study were to investigate the long-term impact of L4/L5 disc puncture on disc degeneration and the subsequent emergence, persistence and underlying mechanisms of axial and radiating LBP in mice. L4-L5 discs were punctured on the ventral aspect with a 30 gauge needle in 3-month old female CD1 mice and the development of behavioral signs of axial discomfort (tail suspension and grip force), radiating hypersensitivity (von Frey and acetone), and motor impairment (rotarod) were monitored...
May 22, 2018: Pain
Brian C Clark, David W Russ, Masato Nakazawa, Christopher R France, Stevan Walkowski, Timothy D Law, Megan Applegate, Niladri Mahato, Samuel Lietkam, James Odenthal, Daniel Corcos, Simeon Hain, Betty Sindelar, Robert J Ploutz-Snyder, James S Thomas
BACKGROUND: Low back pain (LBP) is one of the most common reasons for seeking medical care. Manipulative therapies are a common treatment for LBP. Few studies have compared the effectiveness of different types of manipulative therapies. Moreover, the physiologic mechanisms underlying these treatments are not fully understood. Herein, we present the study protocol for The Researching the Effectiveness of Lumbar Interventions for Enhancing Function Study (The RELIEF Study). METHODS AND STUDY DESIGN: The RELIEF Study is a Phase II RCT with a nested mechanistic design...
July 2018: Contemporary Clinical Trials
Erik L Werner, Ida Løchting, Kjersti Storheim, Margreth Grotle
BACKGROUND: Cluster randomized controlled trials are often used in research in primary care but creates challenges regarding biases and confounders. We recently presented a study on low back pain from primary care in Norway with equal effects in the intervention and the control group. In order to understand the specific mechanisms that may produce biases in a cluster randomized trial we conducted a focus group study among the participating health care providers. The aim of this study was to understand how the participating providers themselves influenced on the study and thereby possibly on the results of the cluster randomized controlled trial...
May 22, 2018: BMC Family Practice
Tim K S Lui, Sharon M H Tsang, Anthony W L Kwok
This study examined the changes in spinal kinematics and muscle recruitment of the lumbopelvic region associated with prolonged squatting. Eight subjects with chronic nonspecific low back pain (LBP) and eight asymptomatic subjects (AS) performed squat-to-stand and reverse movements, before and immediately after 15 min deep-squatting. Within-group and between-group differences in lumbopelvic kinematics and electromyographic activity acquired in lumbar erector spinae (ES), gluteus maximus (GM), and vastus lateralis (VL) were analyzed...
May 16, 2018: International Journal of Environmental Research and Public Health
R Da Silva Santos, G Galdino
Exercise-induced analgesia is a phenomenon discussed worldwide. This effect began to be investigated in the early 1970s in healthy individuals and rodents during and after an acute or chronic session of running or swimming. Thereafter, studies found this effect was also induced by resistance exercises. Over the years, many studies have demonstrated the importance of exercise-induced analgesia in relieving pain caused by different conditions, such as fibromyalgia, low back pain, neuropathy, and osteoarthritis...
February 2018: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Anna Marcuzzi, Paul J Wrigley, Catherine M Dean, Petra L Graham, Julia M Hush
Introduction: Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. Objectives: This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset...
March 2018: Pain Reports (Baltimore, Md.)
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
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