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Low back pain guidelines

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https://www.readbyqxmd.com/read/29758581/-managment-of-acute-low-back-pain-without-trauma-an-algorithm
#1
Carolin Melcher, Bernd Wegener, Volkmar Jansson, Wolf Mutschler, Karl-Georg Kanz, Christof Birkenmaier
BACKGROUND: Low back pain is a common problem for primary care providers, outpatient clinics and A&E departments. The predominant symptoms are those of so-called "unspecific back pain", but serious pathologies can be concealed by the clinical signs. Especially less experienced colleagues have problems in treating these patients, as - despite the multitude of recommendations and guidelines - there is no generally accepted algorithm. METHODS: After a literature search (Medline/Cochrane), 158 articles were selected from 15,000 papers and classified according to their level of evidence...
May 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29754321/chronic-low-back-pain-a-mini-review-on-pharmacological-management-and-pathophysiological-insights-from-clinical-and-pre-clinical-data
#2
REVIEW
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
https://www.readbyqxmd.com/read/29751801/effectiveness-of-a-multifaceted-implementation-strategy-compared-to-usual-care-on-low-back-pain-guideline-adherence-among-general-practitioners
#3
Arnela Suman, Frederieke G Schaafsma, Peter M van de Ven, Pauline Slottje, Rachelle Buchbinder, Maurits W van Tulder, Johannes R Anema
BACKGROUND: To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. METHODS: The implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29742789/-case-report-opioid-therapy-for-chronic-low-back-pain
#4
Alexander Schnabel, Roland Haaga, Heike L Rittner
Within this case report we describe and discuss the treatment of a patient with chronic low back pain complaining about severe pain, reduced functionality and symptoms of depression, who was treated with long-term opioids (480 mg morphine equivalents). According to the recommendation of current guidelines we successfully reduced the opioid daily dose and discharged the patient with 28 mg morphine equivalents, improved physical functionality and reduced chronic pain intensity following a specific interdisciplinary pain rehabilitation programme for seniors...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29730460/imaging-for-low-back-pain-is-clinical-use-consistent-with-guidelines-a-systematic-review-and-meta-analysis
#5
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 recognised. The converse is also possible, although rarely considered. The extent of these two problems is presently unclear. PURPOSE: 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: Systematic review and meta-analysis PATIENT SAMPLE: Patients with low back pain presenting to primary care...
May 3, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29681630/guidelines-on-the-application-of-the-clinical-practice-guideline-on-low-back-pain
#6
José María Jiménez-Ávila, Erik Noe Rubio-Flores, Arelhi Catalina González-Cisneros, Jaime Eduardo Guzmán-Pantoja, Elsa Armida Gutiérrez-Román
Introduction: Low back pain is defined as pain in the upper portion of T12 and below the crease of the buttocks and functional limitation. The prevalence of low back pain gradually increases 11.4% per year. In Mexico, the clinical practice guidelines are not followed in handling low back pain, so it is important to systematize medical care more efficient, since resources are scarce. The first level doctor must meet the benchmarks according to patient need, an incomplete anamnesis is performed, inadequate physical examination, misinterpretation of clinical studies, misdiagnosis, ineffective management, and reference to second or third level not justified...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29679728/magnetic-resonance-imaging-of-the-lumbar-spine-determining-clinical-impact-and-potential-harm-from-overuse
#7
Nathan M Wnuk, Tarik K Alkasab, Daniel I Rosenthal
BACKGROUND: Lumbar spine MRI is frequently said to be "overused" in the evaluation of low-back pain, yet data concerning the extent of overuse and on potential harmful effects are lacking. PURPOSE: To determine the proportion of examinations with a detectable impact on patient care (actionable outcomes). STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: 5,365 outpatient lumbar spine MR examinations OUTCOME MEASURES: Actionable outcomes included: 1) findings leading to an intervention making use of anatomical information such as surgery; 2) new diagnoses of cancer, infection, or fracture; or 3) following known lumbar spine pathology...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29668650/impact-of-an-advanced-imaging-utilization-review-program-on-downstream-health-care-utilization-and-costs-for-low-back-pain
#8
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...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29614943/primary-care-management-of-non-specific-low-back-pain-key-messages-from-recent-clinical-guidelines
#9
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
https://www.readbyqxmd.com/read/29606335/spinal-manipulative-therapy-and-other-conservative-treatments-for-low-back-pain-a-guideline-from-the-canadian-chiropractic-guideline-initiative
#10
André E Bussières, Gregory Stewart, Fadi Al-Zoubi, Philip Decina, Martin Descarreaux, Danielle Haskett, Cesar Hincapié, Isabelle Pagé, Steven Passmore, John Srbely, Maja Stupar, Joel Weisberg, Joseph Ornelas
OBJECTIVE: The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. METHODS: The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention...
March 29, 2018: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/29595009/-low-back-and-radicular-pain-which-management-in-2018
#11
P Jonckheer, C Demoulin, A Desomer, P van Wambeke
Both frequent reason for consultation and cause of absence at work, low back pain is a notorious public health concern. The Belgian Health Care Knowledge Centre (KCE) has been surrounded by 31 clinicians from different disciplines to develop a guideline covering the entire management of low back and radicular pain. A recently published guideline of the British National Institute for Health and Care Excellence (NICE) was largely used as a starting point and adapted to the Belgian context.
March 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29592802/physiotherapists-views-of-implementing-a-stratified-treatment-approach-for-patients-with-low-back-pain-in-germany-a-qualitative-study
#12
Sven Karstens, Pauline Kuithan, Stefanie Joos, Jonathan C Hill, Michel Wensing, Jost Steinhäuser, Katja Krug, Joachim Szecsenyi
BACKGROUND: The STarT-Back-Approach (STarT: Subgroups for Targeted Treatment) was developed in the UK and has demonstrated clinical and cost effectiveness. Based on the results of a brief questionnaire, patients with low back pain are stratified into three treatment groups. Since the organisation of physiotherapy differs between Germany and the UK, the aim of this study is to explore German physiotherapists' views and perceptions about implementing the STarT-Back-Approach. METHODS: Three two-hour think-tank workshops with physiotherapists were conducted...
March 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29579232/guidelines-for-composing-and-assessing-a-paper-on-the-treatment-of-pain-a-practical-application-of-evidence-based-medicine-principles-to-the-mint-randomized-clinical-trials
#13
Zachary L McCormick, Yakov Vorobeychik, Jatinder S Gill, Ming-Chih J Kao, Belinda Duszynski, Matthew Smuck, Milan P Stojanovic
Objective: To perform a thorough assessment of the recently published Mint Trials in order to illustrate how to read and analyze a study critically, according to principles of evidence-based medicine. Design: Narrative review. Method: We have applied the recently published guidelines for composing and assessing studies on the treatment of pain to a recently published article describing a large study that claimed its "findings do not support the use of radiofrequency denervation to treat chronic low back pain...
March 20, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29573872/prevention-and-treatment-of-low-back-pain-evidence-challenges-and-promising-directions
#14
REVIEW
Nadine E Foster, Johannes R Anema, Dan Cherkin, Roger Chou, Steven P Cohen, Douglas P Gross, Paulo H Ferreira, Julie M Fritz, Bart W Koes, Wilco Peul, Judith A Turner, Chris G Maher
Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness...
March 20, 2018: Lancet
https://www.readbyqxmd.com/read/29549815/a-systematic-review-and-meta-analysis-of-the-reliability-and-validity-of-sensorimotor-measurement-instruments-in-people-with-chronic-low-back-pain
#15
REVIEW
Katja Ehrenbrusthoff, Cormac G Ryan, Christian Grüneberg, Denis J Martin
BACKGROUND: Deficits in the sensorimotor system and its peripheral and central processing of the affected body part might be a contributing factor to chronic low back pain (CLBP). Hence, sensorimotor assessment is important. Valid and reliable sensorimotor measurement instruments are needed. OBJECTIVE: To investigate the reliability and validity of sensorimotor measurement instruments for people with chronic low back pain (CLBP). DESIGN: Systematic review and meta-analysis...
June 2018: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/29526837/pain-perception-and-low-back-pain-functional-disability-after-a-10-week-core-and-mobility-training-program-a-pilot-study
#16
Vicente Pinheiro Lima, Rodolfo de Alkmim Moreira Nunes, Jurandir Baptista da Silva, Gabriel Andrade Paz, Marco Jesus, Juliana Brandão Pinto de Castro, Estélio Henrique Martin Dantas, Rodrigo Gomes de Souza Vale
BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the effects of a 10-week core and mobility training program on pain perception and low back disability score in professors, students and employees of a university. METHODS: Twenty-four individuals of a university who previously reported pain and low back disability were randomly assigned to an experimental group (EG; n= 8) that received 2 weekly sessions of 50 minutes of core and mobility training for 10 weeks; or to a control group (CG; n= 16)...
March 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/29509613/red-flags-for-low-back-pain-are-not-always-really-red-a-prospective-evaluation-of-the-clinical-utility-of-commonly-used-screening-questions-for-low-back-pain
#17
Ajay Premkumar, William Godfrey, Michael B Gottschalk, Scott D Boden
BACKGROUND: Low back pain has a high prevalence and morbidity, and is a source of substantial health-care spending. Numerous published guidelines support the use of so-called red flag questions to screen for serious pathology in patients with low back pain. This paper examines the effectiveness of red flag questions as a screening tool for patients presenting with low back pain to a multidisciplinary academic spine center. METHODS: We conducted a retrospective review of the cases of 9,940 patients with a chief complaint of low back pain...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29503036/randomized-open-labbel-non-inferiority-trial-of-acetaminophen-or-loxoprofen-for-patients-with-acute-low-back-pain
#18
Kenji Miki, Tatsunori Ikemoto, Kazuhiro Hayashi, Young-Chang Arai, Miho Sekiguchi, Kenrin Shi, Takahiro Ushida
BACKGROUND: Current worldwide clinical practice guidelines recommend acetaminophen as the first option for the treatment of acute low back pain. However, there is no concrete evidence regarding whether acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) is more effective for treating acute low back pain (LBP) in Japan. The present study aimed to investigate whether acetaminophen treatment for acute musculoskeletal pain was comparable with loxoprofen (a traditional NSAID in Japan) treatment...
May 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29499690/development-of-the-japanese-core-outcome-measures-index-comi-cross-cultural-adaptation-and-psychometric-validation
#19
Ko Matsudaira, Hiroyuki Oka, Yasushi Oshima, Hirotaka Chikuda, Yuki Taniguchi, Yoshitaka Matsubayashi, Mika Kawaguchi, Emiko Sato, Haruka Murano, Thomas Laurent, Sakae Tanaka, Anne F Mannion
BACKGROUND: The patient-rated Core Outcome Measures Index (COMI) assesses the multidimensional impact of back problems on the sufferer. The brevity and comprehensibility of the tool make it practical for use in clinical and research settings. Although the COMI has been cross-culturally adapted in various languages worldwide, there is currently no Japanese version. The aim of this study was to develop a Japanese version of the COMI by: (1) performing a cross-cultural adaptation of the English version and (2) evaluating the psychometric properties of the Japanese version of the COMI in Japanese volunteers with chronic back problems...
March 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29492717/the-global-spine-care-initiative-a-systematic-review-for-the-assessment-of-spine-related-complaints-in-populations-with-limited-resources-and-in-low-and-middle-income-communities
#20
REVIEW
Margareta Nordin, Kristi Randhawa, Paola Torres, Hainan Yu, Scott Haldeman, O'Dane Brady, Pierre Côté, Carlos Torres, Michael Modic, Rajani Mullerpatan, Christine Cedraschi, Roger Chou, Emre Acaroğlu, Eric L Hurwitz, Nadège Lemeunier, Jean Dudler, Anne Taylor-Vaisey, Erkin Sönmez
PURPOSE: The purpose of this systematic literature review was to develop recommendations for the assessment of spine-related complaints in medically underserved areas with limited resources. METHODS: We conducted a systematic review and best evidence synthesis of guidelines on the assessment of spine-related complaints. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation-II criteria. Low risk of bias clinical practice guidelines was used to develop recommendations...
February 28, 2018: European Spine Journal
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