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pain management ,spine ,low back pain,joint pain management

Dong-Hwa Heo, Choon-Keun Park
BACKGROUND: Osteoporosis is an important problem in those of advanced age. Osteoporosis can induce sacral insufficiency fractures (SIFs). As average life expectancy increases, the number of patients with osteoporotic SIFs also increases. Osteoporotic SIFs cause severe low back pain and immobilization. Treatment of SIFs varies from analgesia to surgery. OBJECTIVES: To describe our experience and assess the safety and effectiveness of minimally invasive percutaneous sacroplasty in patients with osteoporotic SIFs...
February 2017: Pain Physician
Pedro Ribeiro da Cunha, António Judice Peliz, Marcos Barbosa
PURPOSE: Although gout is a common metabolic disorder, it usually affects distal joints of the appendicular skeleton. Axial spine involvement is rare, with only 131 cases reported in the literature. The authors report a rare case of lumbar spinal gout mimicking a spinal meningioma. METHODS: A 77-year-old man with a history of gout presented with chronic low back pain and progressive paraparesis. Imaging revealed a lumbar spine compressive mass lesion with a dural tail signal...
November 5, 2016: European Spine Journal
Julius Dengler, Bengt Sturesson, Djaya Kools, Domenico Prestamburgo, Daniel Cher, Eddie van Eeckhoven, Emanuel Erk, Robert Pflugmacher, Peter Vajkoczy
BACKGROUND: The first results from the randomized, controlled iFuse Implant System Minimally Invasive Arthrodesis (iMIA) trial showed that minimally invasive surgical management (MISM) of low back pain originating from the sacroiliac joint (SIJ) by placing transarticular triangular titanium implants reduced pain more effectively than conservative management (CM). We now conducted a separate analysis of the iMIA data to assess whether the referred leg pain (RLP) component of SIJ-associated pain may also be affected by MISM or CM...
November 2016: Acta Neurochirurgica
Seth Peterson, Cheri Hodges
BACKGROUND: Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation. CASE DESCRIPTION: A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS...
September 2016: Journal of Manual & Manipulative Therapy
Gabriella R Goshtigian, Brian T Swanson
BACKGROUND: Despite the multidirectional quality of human movement, common measurement procedures used in physical therapy examination are often uni-planar and lack the ability to assess functional complexities involved in daily activities. Currently, there is no widely accepted, validated standard to assess movement quality. The Selective Functional Movement Assessment (SFMA) is one possible system to objectively assess complex functional movements. The purpose of this case report is to illustrate the application of the SFMA as a guide to the examination, evaluation, and management of a patient with non-specific low back pain (LBP)...
August 2016: International Journal of Sports Physical Therapy
Matthew J Goldstein, James Bruffey, Robert K Eastlack
STUDY DESIGN: Case report. OBJECTIVE: To report a case of direct pars osteosynthesis using computed topography (CT) navigation, image guided cortically placed screws with curvilinear subspinous modular link. SUMMARY OF BACKGROUND DATA: Spondylolysis fracture is commonly encountered in athletes who subject their spines to repetitive hyperextension stress. Initial treatment is nonoperative, consisting of rest, activity modification, physical therapy, and/or bracing...
December 1, 2016: Spine
Alaattin Yurt, Mehmet Seçer, Murat Aydın, Emrah Akçay, Ali Rıza Ertürk, İsmail Akkol, Hakan Yılmaz, Mahmut Necdet Palaz
INTRODUCTION: Juxtafacet cysts of the lumbar spine are extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. The aim of this study is to evaluate the efficacy of surgery and address controversial issues in the treatment of symptomatic juxta facet cysts in the Neurosurgical Department of our hospital and review of the literature. METHODS: Data from seven patients (age range 58-68 years, mean age 63 years) with low back and radicular leg pain due to a lumbar facet joint cyst were retrospectively analyzed...
May 2016: International Journal of Surgery
Mary Morris, Janice Pellow, Elizabeth Margaret Solomon, Tebogo Tsele-Tebakang
CONTEXT: Osteoarthritis (OA) is a common cause of chronic low-back pain (CLBP) and can be managed with drug therapy and physiotherapy. Homeopathic remedies may assist managing OA; however, research that supports their effectiveness is limited. OBJECTIVES: The study aimed to investigate the efficacy of a homeopathic complex in combination with physiotherapy in treating CLBP due to OA. DESIGN: The study was a 6-wk, randomized, double-blind, placebo-controlled pilot...
January 2016: Alternative Therapies in Health and Medicine
J Vaneet Kumar, Tukaram S Dudhamal, Sanjay Kumar Gupta, Vyasadev Mahanta
BACKGROUND: Lifetime incidence of low back pain is 50-70% and incidence of clinically significant sciatica due to lumbar disc prolapse occurs in 4-6% of the population. Low back pain and sciatica is major cause of morbidity throughout the world. There is only conservative treatment giving short-term relief in pain or surgical intervention with side-effect. There is need to find out quick relief from pain in today's era as it affects physical as well as mental and social life of patients...
July 2014: Ayu
W Michael Hooten, Steven P Cohen
Low back pain (LBP) is a leading cause of disability worldwide. In the absence of a classification system for pain syndromes, classification of LBP on the basis of the distribution of pain as axial (pain generally localized to the low back) or radicular neuropathic (pain radiating to the lower extremities) is relevant to clinical practice because the distribution of pain is often a corollary of frequently occurring disease processes involving the lumbar spine. Common sources of axial LBP include the intervertebral disc, facet joint, sacroiliac joint, and paraspinal musculature, whereas common sources of radicular pain include a herniated intervertebral disc and spinal stenosis...
December 2015: Mayo Clinic Proceedings
Wayne Powell, Simone F C Knaap
OBJECTIVE: The purpose of this case study is to present chiropractic management of a patient with chronic low back pain by focusing on the craniomandibular system. CLINICAL FEATURES: A 37-year-old man consulted a chiropractor for pain in the lumbosacral area with radiation down the anterolateral side of the upper left leg. The symptoms started after a fall the previous year. Examination showed a post-traumatic chronic L4-L5 facet dysfunction and left sacro-iliac joint dysfunction...
March 2015: Journal of Chiropractic Medicine
Kelvin J Murray, Michael F Azari
OBJECTIVE: The purpose of this case report is to describe chiropractic management of an elderly man with untreated bilateral hip joint dysplasia presenting with mild acute mechanical low back pain. CLINICAL FEATURES: A 75-year-old man presented with an insidious-onset intermittent low back pain of 3 days' duration. Physical examination findings supported a mechanical cause for mild acute low back pain. Plain radiography revealed dysplasia of hip joints with absence of femoral heads and necks and bilateral high dislocation...
March 2015: Journal of Chiropractic Medicine
Sumit H Rana, Payam Farjoodi, Sean Haloman, Pascual Dutton, Arvin Hariri, Samuel R Ward, Steven R Garfin, Douglas G Chang
BACKGROUND: Sacroiliac joint (SI) pain is increasingly being recognized as a source of low back pain. Injections and percutaneous type procedures are performed to treat symptomatic joints. However, there are limited studies available assessing the anatomy of the SI joint in vivo among patients with pain. OBJECTIVES: The purpose of this study was to provide more precise information on the dimensions and orientation of the SI joint using a new technique for the radiographic evaluation of this joint...
November 2015: Pain Physician
Anuj Jain, Suruchi Jain, Anil Agarwal, Sanjay Gambhir, Chetna Shamshery, Amita Agarwal
INTRODUCTION: Conventional radiologic modalities provide details only about the anatomic aspect of the various structures of the spine. Frequently the structures that show abnormal morphology may not be the cause of low back pain (LBP). Functional imaging in the form of bone scan along with single photon emission computerized tomography (SPECT/CT) may be helpful in identifying structures causing pain, whether morphologically normal or not. The objective of this study is to evaluate the role of bone scan with SPECT/CT in management of patients with LBP...
December 2015: Clinical Journal of Pain
Danielle Casagrande, Zbigniew Gugala, Shannon M Clark, Ronald W Lindsey
Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging...
September 2015: Journal of the American Academy of Orthopaedic Surgeons
Éric Toussirot
Spondyloarthritis (SpA) is usually observed in young patients while onset in the elderly is less common. Late-onset forms of SpA may become more common due to longer life expectancy. The clinical spectrum of late-onset SpA is as broad as in young people, with a predominance of peripheral SpA over pure axial disease. The Assessment of SpondyloArthritis international Society (ASAS) has developed new criteria for axial or peripheral SpA that allow patients aged under 45 years at the time of disease onset to be identified...
July 2015: Drugs & Aging
Jonathan Sylvain, Michael P Reiman
STUDY DESIGN: Case Report. BACKGROUND AND PURPOSE: The purpose of this case report is to describe the clinical reasoning process involved with the differential diagnosis and management of a 69 year-old male runner reporting a six month history of insidious onset of left sided low back and buttock pain of low to medium degree of irritability. The case presented describes the utilization of clinical reasoning by a clinician in fellowship training when a patient with atypical adverse neurodynamic dysfunction related to running was encountered...
April 2015: International Journal of Sports Physical Therapy
Gijsbert M Overdevest, Wilco Jacobs, Carmen Vleggeert-Lankamp, Claudius Thomé, Robert Gunzburg, Wilco Peul
BACKGROUND: The gold standard treatment for symptomatic lumbar stenosis refractory to conservative management is a facet-preserving laminectomy. New techniques of posterior decompression have been developed to preserve spinal integrity and to minimise tissue damage by limiting bony decompression and avoiding removal of the midline structures (i.e. spinous process, vertebral arch and interspinous and supraspinous ligaments). OBJECTIVES: To compare the effectiveness of techniques of posterior decompression that limit the extent of bony decompression or avoid removal of posterior midline structures of the lumbar spine versus conventional facet-preserving laminectomy for the treatment of patients with degenerative lumbar stenosis...
2015: Cochrane Database of Systematic Reviews
Emily M Lindley, Brianna N Patti, Matthew Taylor, Evalina L Burger, Vikas V Patel
BACKGROUND: Ehlers-Danlos syndrome (EDS) is a heterogeneous collection of connective tissue disorders characterized by varying degrees of skin hyperextensibility, joint hypermobility, and tissue fragility. Surgical treatment of EDS patients is complicated by the extreme fragility of their vessels and tissues. The purpose of this case report is to present the management of an EDS patient with debilitating low-back pain. METHODS: A 52-year-old woman with a clinical diagnosis of EDS presented with degenerative disc disease at L4-5 that had not been alleviated by previous microdiscectomies...
2012: International Journal of Spine Surgery
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Mark V Boswell
STUDY DESIGN: Comparative assessment of randomized controlled trials of caudal and lumbar interlaminar epidural injections in chronic lumbar discogenic pain. OBJECTIVE: To assess the comparative efficacy of caudal and lumbar interlaminar approaches of epidural injections in managing axial or discogenic low back pain. SUMMARY OF BACKGROUND DATA: Epidural injections are commonly performed utilizing either a caudal or lumbar interlaminar approach to treat chronic lumbar axial or discogenic pain, which is pain exclusive of that associated with a herniated intervertebral disc, or that is due to degeneration of the zygapophyseal joints, or due to dysfunction of the sacroiliac joints, respectively...
2015: International Journal of Medical Sciences
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