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Lower back pain...

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Sachin S Saboo, Donald Di Salvo
Perineural cysts may be discovered incidentally on pelvic sonography and can easily mimic more common gynecologic masses. We report the complex cystic adnexal mass like appearance of these incidentally noted cysts which mimicked malignancy on sonography in a postmenopausal female, with stage I breast cancer and vaginal spotting.
January 2013: Journal of Clinical Ultrasound: JCU
Corrado Lucantoni, Khoi D Than, Anthony C Wang, Juan M Valdivia-Valdivia, Cormac O Maher, Frank La Marca, Paul Park
The primary aim of our study was to provide a comprehensive review of the clinical, imaging, and histopathological features of Tarlov cysts (TCs) and to report operative and nonoperative management strategies in patients with sacral TCs. A literature review was performed to identify articles that reported surgical and nonsurgical management of TCs over the last 10 years. Tarlov cysts are often incidental lesions found in the spine and do not require surgical intervention in the great majority of cases. When TCs are symptomatic, the typical clinical presentation includes back pain, coccyx pain, low radicular pain, bowel/bladder dysfunction, leg weakness, and sexual dysfunction...
December 2011: Neurosurgical Focus
Jianqiang Xu, Yongdong Sun, Xin Huang, Wenzhong Luan
BACKGROUND: There has been no consensus on the optimal treatment of symptomatic sacral perineural cysts. Most previous reports concerning the management methods were either sporadic case reports or a series of limited cases. This study is to further optimize the management for patients with symptomatic sacral perineural cysts by analyzing the outcomes of a cohort of patients who were treated with different strategies. METHODS AND FINDINGS: We reviewed the outcomes of 15 patients with symptomatic sacral perineural cysts who were managed by three different modalities from 1998 through 2010...
2012: PloS One
M B Owlia, A Salimzadeh, Gh Alishiri, A Haghighi
INTRODUCTION: Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI. METHODS: 84 patients with newly exacerbated lumbar radicular pain were randomly al located into two groups...
March 2007: Singapore Medical Journal
Corinna Leonhardt, Katrin Kuss, Annette Becker, Heinz-Dieter Basler, Jeroen de Jong, Brigitta Flatau, Marjan Laekeman, Peter Mattenklodt, Matthias Schuler, Johan Vlaeyen, Sabine Quint
BACKGROUND AND PURPOSE: Fear-avoidance beliefs in older adults with chronic low back pain (CLBP) can lead to disability. Graded exposure-based active physical therapy could be an option to enhance physical ability in older patients with CLBP. The purpose of this study was to develop a standardized graded exposure treatment according to the fear-avoidance model of musculoskeletal pain for older patients with CLBP and to examine its effectiveness and feasibility in the German health care system...
April 7, 2016: Journal of Geriatric Physical Therapy
Albert Tu, Kerry Creedon, Ramesh Sahjpaul
Perineural cysts are common lesions of the sacral spine. They have rarely been reported in a presacral location, leading to their misdiagnosis as a gynecological lesion. The authors report the second such case, in a patient undergoing fenestration of what was presumed to be a benign pelvic cyst, and the resultant high-flow CSF leak that occurred. They describe the clinical presentation and manifestations of intracranial hypotension, as well as the pertinent investigations. They also review the literature for the best management options for this condition...
September 2014: Journal of Neurosurgery. Spine
Luana Colloca, Paul Enck, David DeGrazia
Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like effects...
August 2016: Pain
Kelvin L Robertson, Laurence A G Marshman
SETTING: There is currently a gross lack of evidence base guiding the medical management of chronic sciatica (CS). Only scant previous studies have assessed gabapentin (GBP) in CS. Extrapolating NICE-UK guidelines, prescribing authorities often insist on trialling anti-depressants (e.g., amytriptyline, AMP) as a first line for neuropathic pain states such as CS. When super-adding second-line agents, such as GBP, NICE-UK encourages overlap with first-line agents to avoid decreased pain-control...
April 3, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Ui-Cheol Jeong, Jae-Heon Sim, Cheol-Yong Kim, Gak Hwang-Bo, Chan-Woo Nam
[Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group...
December 2015: Journal of Physical Therapy Science
Vikram B Patel, Ronald Wasserman, Farnad Imani
CONTEXT: Lower back pain is considered to be one of the most common complaints that brings a patient to a pain specialist. Several modalities in interventional pain management are known to be helpful to a patient with chronic low back pain. Proper diagnosis is required for appropriate intervention to provide optimal benefits. From simple trigger point injections for muscular pain to a highly complex intervention such as a spinal cord stimulator are very effective if chosen properly. The aim of this article is to provide the reader with a comprehensive reading for treatment of lower back pain using interventional modalities...
August 2015: Anesthesiology and Pain Medicine
Roger Chou, Amir Qaseem, Vincenza Snow, Donald Casey, J Thomas Cross, Paul Shekelle, Douglas K Owens
RECOMMENDATION 1: Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain (strong recommendation, moderate-quality evidence). RECOMMENDATION 2: Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back pain (strong recommendation, moderate-quality evidence)...
October 2, 2007: Annals of Internal Medicine
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