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Algorithm low back pain treatment

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https://www.readbyqxmd.com/read/27880650/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-xi-dementia
#1
Rollin Wright, Monica Malec, Joseph W Shega, Eric Rodriguez, Joseph Kulas, Lisa Morrow, Juleen Rodakowski, Todd Semla, Debra K Weiner
: OBJECTIVE : To present the 11th in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of 12 important contributions to pain and disability in older adults with CLBP. This article focuses on dementia. METHODS:  A modified Delphi technique was used to develop an algorithm for an approach to treatment for older adults living with CLBP and dementia...
November 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27810456/considerations-in-spinal-fusion-surgery-for-chronic-lumbar-pain-psychosocial-factors-rating-scales-and-perioperative-patient-education-a-review-of-the-literature
#2
REVIEW
Daniel Gaudin, Brianna M Krafcik, Tarek R Mansour, Ahmed Alnemari
OBJECTIVE: This literature review was conducted to better understand the factors associated with optimal post-operative results following lumbar spinal fusion for chronic back pain, and the current tools used for evaluation. BACKGROUND: Despite widespread use of lumbar spinal fusion as a treatment for back pain, outcomes remain variable. Optimizing patient selection can help to reduce adverse outcomes. METHODS: The PubMed database was searched for clinical trials related to psychosocial determinants of outcome following lumbar spinal fusion surgery, evaluation of commonly used patient subjective outcome measures, and perioperative cognitive, behavioral, and educational therapies...
October 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27605679/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-x-sacroiliac-joint-syndrome
#3
Patrick J Polsunas, Gwendolyn Sowa, Julie M Fritz, Angela Gentili, Natalia E Morone, Srinivasa Naga Raja, Eric Rodriguez, Kenneth Schmader, Joel D Scholten, Debra K Weiner
OBJECTIVE: To present an algorithm of sequential treatment options for managing sacroiliac joint (SIJ) pain in the setting of chronic low back pain (CLBP) in the older adult. This is the tenth part in a series, and includes an illustrative clinical case. METHODS: The stepped care drug table and evaluation and treatment algorithm were created following a thorough literature review of approaches and subsequent analysis through a modified Delphi process. The principal investigator developed the initial draft, which was refined for content by an interdisciplinary panel of five experts...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27399403/124%C3%A2-low-back-pain-relief-with-a-new-32-contact-surgical-lead-and-neural-targeting-algorithm
#4
Julie G Pilitsis, Giancarlo Barolat, Joshua M Rosenow, James J Brennan, Alexander S Bailey, Jeffrey M Epstein, Blake Hammond, Clark Metzger, Dat Huynh, Kristen Lechleiter, Nitzan Mekel-Bobrov
INTRODUCTION: Treatment of low-back pain using Spinal Cord Stimulation (SCS) has been historically challenging. Advances in surgical leads and programming capabilities have been thought to potentially enable improved low-back pain relief using SCS. A recently introduced 32-contact surgical lead, which couples multiple independent current control (MICC) and anatomically based neural targeting stimulation algorithms, allows for patient-specific programming optimization. We present here a real-world, observational study of this 32-contact surgical lead...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27346887/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-ix-anxiety
#5
Jordan F Karp, Elizabeth A DiNapoli, Julie Wetherell, Chloe Bolon, Eric Rodriguez, Joseph Shega, Debra K Weiner
OBJECTIVE: As a part of a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults, this article focuses on anxiety-a significant contributor of reduced health-related quality of life, increased use of medical services, and heightened disability in older adults with CLBP. METHODS: A modified Delphi technique was used to develop an algorithm for the screening and clinical care of older adults with CLBP and anxiety. A 4-member content expert panel and a nine-member primary care panel were involved in this iterative development process...
August 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27330155/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-viii-lateral-hip-and-thigh-pain
#6
Monica Rho, Alejandra Camacho-Soto, Abby Cheng, Mark Havran, Natalia E Morone, Eric Rodriguez, Joseph Shega, Debra K Weiner
OBJECTIVE: This article presents an evidence-based algorithm to assist primary care providers with the diagnosis and management of lateral hip and thigh pain in older adults. It is part of a series that focuses on coexisting pain patterns and contributors to chronic low back pain (CLBP) in the aging population. The objective of the series is to encourage clinicians to take a holistic approach when evaluating and treating CLBP in older adults. METHODS: A content expert panel and a primary care panel collaboratively used the modified Delphi approach to iteratively develop an evidence-based diagnostic and treatment algorithm...
June 21, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27215046/deep-transcranial-magnetic-stimulation-a-promising-drug-free-treatment-modality-in-the-treatment-of-chronic-low-back-pain
#7
Erin Yates, Ganesh Balu
UNLABELLED: Deep Transcranial Magnetic Stimulation (dTMS) is the next generation of technology used to treat Major Depressive Disorder (MDD). dTMS has been proven to be a safe and effective treatment modality for MDD and may have secondary benefits in patients with chronic low back pain by reducing pain related morbidity. We are presenting two case studies with MDD and chronic low back pain to demonstrate the effectiveness of both the antidepressant and analgesic effects of dTMS. BACKGROUND: Transcranial Magnetic Stimulation (rTMS) utilizes MRI-strength magnetic pulses outside the cranium to stimulate the brain to a depth of approximately 1 cm...
March 2016: Delaware Medical Journal
https://www.readbyqxmd.com/read/27173512/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-vii-insomnia
#8
REVIEW
Adam D Bramoweth, Jenna G Renqvist, Anne Germain, Daniel J Buysse, Angela Gentili, Gary Kochersberger, Eric Rodriguez, Michelle I Rossi, Debra K Weiner
OBJECTIVE : To present the seventh in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on insomnia and presents a treatment algorithm for managing insomnia in older adults, along with a representative clinical case. METHODS : A modified Delphi process was used to develop the algorithm and supportive materials. A multidisciplinary expert panel representing expertise in health psychology and sleep medicine developed the algorithm and supporting documents that were subsequently refined through an iterative process of input from a primary care provider panel...
May 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26962233/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-vi-lumbar-spinal-stenosis
#9
Julie M Fritz, Sean D Rundell, Paul Dougherty, Angela Gentili, Gary Kochersberger, Natalia E Morone, Srinivasa Naga Raja, Eric Rodriguez, Michelle I Rossi, Joseph Shega, Gwendolyn Sowa, Debra K Weiner
OBJECTIVE: . To present the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. METHODS: . The evaluation and treatment algorithm, a table articulating the rationale for the individual algorithm components, and stepped-care drug recommendations were developed using a modified Delphi approach...
March 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26768183/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-v-maladaptive-coping
#10
Elizabeth A DiNapoli, Michael Craine, Paul Dougherty, Angela Gentili, Gary Kochersberger, Natalia E Morone, Jennifer L Murphy, Juleen Rodakowski, Eric Rodriguez, Stephen Thielke, Debra K Weiner
OBJECTIVE: As part of a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults, this article focuses on maladaptive coping--a significant contributor of psychological distress, increased pain, and heightened disability in older adults with CLBP. METHODS: A modified Delphi technique was used to develop a maladaptive coping algorithm and table providing the rationale for the various components of the algorithm. A seven-member content expert panel and a nine-member primary care panel were involved in the iterative development of the materials...
January 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26591318/-therapeutic-algorithm-for-low-back-pain
#11
REVIEW
T S Illés, D Schiopu, R Ouahes, W Penders, P F Reynders
Low back pain (LBP) has become one of the greatest public health problems. The differentiation between specific and non-specific low back pain is mandatory. In the specific low back pain are classified all diseases whose etiology is well defined, quick and accurate diagnosis is required for specific treatment. Other types of low back pain can be considered non-specific. The management of acute low back pain is mainly based on analgesic treatment and early mobilization. Maintaining activity can prevent chronicity of LBP...
September 2015: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/26539754/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-iv-depression
#12
REVIEW
Joseph A Carley, Jordan F Karp, Angela Gentili, Zachary A Marcum, M Carrington Reid, Eric Rodriguez, Michelle I Rossi, Joseph Shega, Stephen Thielke, Debra K Weiner
OBJECTIVE: To present the fourth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of twelve important contributors to pain and disability in older adults with CLBP. This article focuses on depression. METHODS: The evaluation and treatment algorithm, a table articulating the rationale for the individual algorithm components, and stepped-care drug recommendations were developed using a modified Delphi approach...
November 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26487473/lumbar-spinal-degenerative-microinstability-hype-or-hope-proposal-of-a-new-classification-to-detect-it-and-to-assess-surgical-treatment
#13
A Landi, F Gregori, C Mancarella, V Maiola, E Maccari, N Marotta, R Delfini
PURPOSE: The stage of unstable dysfunction, also defined as "active discopathy" by Nguyen in 2015 and configuring the first phase of the degenerative cascade described by Kirkaldy-Willis, has specific pathoanatomical and clinical characteristics (low back pain) in the interested vertebral segment, without the presence of spondylolisthesis in flexion-extension radiography. This clinical condition has been defined as "microinstability" (MI). The term has currently not been recognized by the scientific community and is subject of debate for its diagnostic challenge...
November 2015: European Spine Journal
https://www.readbyqxmd.com/read/26272644/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-iii-fibromyalgia-syndrome
#14
REVIEW
Gita Fatemi, Meika A Fang, Paula Breuer, Paul E Cherniak, Angela Gentili, Joseph T Hanlon, Jordan F Karp, Natalia E Morone, Eric Rodriguez, Michelle I Rossi, Kenneth Schmader, Debra K Weiner
OBJECTIVE: To present the third in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease localized exclusively to the lumbosacral spine. Each article addresses one of 12 important contributors to pain and disability in older adults with CLBP. This article focuses on fibromyalgia syndrome (FMS). METHODS: A modified Delphi approach was used to create the evaluation and treatment algorithm, the table discussing the rationale behind each of the algorithm components, and the stepped-care drug recommendations...
September 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26233598/acute-anterior-uveitis-and-spondyloarthritis-more-than-meets-the-eye
#15
REVIEW
Muhammad A Khan, Muhammad Haroon, James T Rosenbaum
Ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA) are associated with some extra-articular features, and the most common symptomatic association is with acute anterior uveitis (AAU). Thus, approximately 40 % of patients with AS will experience a sudden onset of a unilateral anterior uveitis sometime during the course of their disease. Patients with AAU, especially those who are HLA-B27 positive, should be questioned about inflammatory low back pain and also evaluated for other clinical features of SpA...
September 2015: Current Rheumatology Reports
https://www.readbyqxmd.com/read/26215900/short-term-effects-of-mulligan-mobilization-with-movement-on-pain-disability-and-kinematic-spinal-movements-in-patients-with-nonspecific-low-back-pain-a-randomized-placebo-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Benjamin Hidalgo, Laurent Pitance, Toby Hall, Christine Detrembleur, Henri Nielens
OBJECTIVE: The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia. METHODS: This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16)...
July 2015: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/26098153/-low-back-pain-in-pregnancy-diagnosis-treatment-options-and-outcomes
#17
REVIEW
Daniel Mühlemann, Malin B Mühlemann
Low back pain in pregnancy is a common occurrence and is mainly caused by hormonal and biomechanical changes. Patients with pregnancy-induced low back pain (PILBP) frequently complain of moderate to severe and disabling pain often restricting their daily activities. In these cases, a “watch and wait” approach cannot be the best solution. On the basis of anamnesis and examination PILBP can be divided into three subgroups: pregnancy-related low back pain (PLBP), pelvic girdle pain (PGP) and the combination of PLBP and PGP...
May 20, 2015: Praxis
https://www.readbyqxmd.com/read/26087225/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-ii-myofascial-pain
#18
Anthony J Lisi, Paula Breuer, Rollin M Gallagher, Eric Rodriguez, Michelle I Rossi, Kenneth Schmader, Joel D Scholten, Debra K Weiner
OBJECTIVE: To present an algorithm of sequential treatment options for managing myofascial pain (MP) in older adults, along with a representative clinical case. METHODS: A modified Delphi process was used to synthesize evidence-based recommendations. A multidisciplinary expert panel developed the algorithm, which was subsequently refined through an iterative process of input from a primary care physician panel. RESULTS: We present an algorithm and supportive materials to help guide the care of older adults with MP, an important contributor to chronic low back pain (CLBP)...
July 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26000680/low-back-pain-guidelines-for-the-clinical-classification-of-predominant-neuropathic-nociceptive-or-central-sensitization-pain
#19
REVIEW
Jo Nijs, Adri Apeldoorn, Hank Hallegraeff, Jacqui Clark, Rob Smeets, Annaleen Malfliet, Enrique L Girbes, Margot De Kooning, Kelly Ickmans
BACKGROUND: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as either predominantly nociceptive, neuropathic, or central sensitization pain. OBJECTIVE: To explain how clinicians can differentiate between nociceptive, neuropathic, and central sensitization pain in patients with LBP...
May 2015: Pain Physician
https://www.readbyqxmd.com/read/25978079/defining-the-inherent-stability-of-degenerative-spondylolisthesis-a-systematic-review
#20
REVIEW
Andrea M Simmonds, Y Raja Rampersaud, Marcel F Dvorak, Nicolas Dea, Angela D Melnyk, Charles G Fisher
OBJECT A range of surgical options exists for the treatment of degenerative lumbar spondylolisthesis (DLS). The chosen technique inherently depends on the stability of the DLS. Despite a substantial body of literature dedicated to the outcome analysis of numerous DLS procedures, no consensus has been reached on defining or classifying the disorder with respect to stability or the role that instability should play in a treatment algorithm. The purpose of this study was to define grades of stability and to develop a guide for deciding on the optimal approach in surgically managing patients with DLS...
August 2015: Journal of Neurosurgery. Spine
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