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At least 1,153 records · Page 64Linked to original sources
PubMed2005

Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial.

BACKGROUND: Chronic low back pain is a common problem that has only modestly effective treatment options. OBJECTIVE: To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain. DESIGN: Randomized, controlled trial. SETTING: A nonprofit, integrated health care system. PATIENTS: 101 adults with chronic low back pain. INTERVENTION: 12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book. MEASUREMENTS: Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and "bothersomeness" of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use. RESULTS: After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to - 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to - 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to - 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to - 1.8]; P < 0.001). LIMITATIONS: Participants in this study were followed for only 26 weeks after randomization. Only 1 instructor delivered each intervention. CONCLUSIONS: Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.

Adult↗
PubMed2004

[Study on lower back pain in home helpers and development of materials for occupational health education].

People who are engaged in home health care services often have to transfer clients while in a half standing posture using repetitious movement including gravitational changes. Transferring heavy patients at homes for the severely mental and physical handicapped is equivalent to the care giving work, listed in the "guideline for prevention of lower back pain in work places" (1994/9/6). The purpose of this study was to investigate incidences of lower back pain and injuries among home helpers as well as to determine the relationship between their level of protective knowledge and prevalence of lower back pain. The results of the study revealed that home helpers complained of a mild type of lower back pain. Although almost all of them had the protective knowledge for lower back injuries that was taught in their training courses, they still felt the need for more knowledge through continuous education regarding protective measures for lower back injuries and pain. Regarding the method of teaching, they want to learn by TV programs, books, texts and self-learning materials. Few of them wanted to learn by computer assisted instructions or the internet. Based upon the results of this study, we have developed new teaching materials for home helpers which explain adequate postures in home care through utilizing their protective knowledge to avoid lower back pain.

Adult↗
PubMed1999

A randomized controlled trial of nonpharmacologic approaches for relief of low back pain during labor.

BACKGROUND: Low back pain is common during labor. Our randomized controlled trial compared the effectiveness of 3 nonpharmacologic approaches for relief of back pain. METHODS: A total of 34 women suffering from low back pain during labor were randomly assigned to receive 1 of 3 treatments: (1) intracutaneous sterile water injections (ISW); (2) transcutaneous electrical nerve stimulation (TENS); and (3) standard care, including back massage, whirlpool bath, and liberal mobilization. Women self-evaluated both intensity and affective dimensions of pain using visual analog scales. Their evaluations of control and satisfaction were assessed using adapted versions of the Labour Agentry Scale and the Labor and Delivery Satisfaction Index. RESULTS: Women in the ISW group rated the intensity and unpleasantness of pain during the experimental period significantly lower than women in the standard care group or the TENS group, (P = .001 and P = .003, respectively). Similar results were observed for intensity (P = .01) and unpleasantness (P = .03) of pain assessed just before delivery or request for an epidural. Mean pain intensity at 15 and 60 minutes after randomization was significantly reduced in the ISW group compared with the 2 other groups. There was no significant difference in the 3 groups in the level of control and satisfaction with labor and delivery, but less women in the ISW group indicated that they would like to receive the same treatment for back pain during another delivery. CONCLUSIONS: Intracutaneous sterile water injections are more effective than standard care (back massage, bath, and mobilization) or transcutaneous electrical nerve stimulation for relieving low back pain during labor.

Analgesia, Obstetrical↗
PubMed1999

Occupational back disability in U.S. Army personnel.

Musculoskeletal disorders represent a prevalent source of outpatient visits, lost work time, hospitalization, and disability in the military. Recent research has identified patterns among military occupations, gender, and musculoskeletal disability. Although back disorders accounted for a high percentage of all cases, little is known about the relationship between job type and disability in soldiers. The present study analyzed 41,750 disability cases to determine (1) prevalence of work-related back disability diagnoses, (2) specific jobs associated with greater risk of back disability, and (3) association among gender, job type, and disability. The results indicate that (1) lumbosacral strain and intervertebral disc syndrome represent the most prevalent diagnoses for back disability, (2) certain occupations were associated with higher back disability risk, and (3) specific jobs were identified in which females experienced higher rates of back disability than males. The nature of these high-risk jobs, and recent research on work disability factors in U.S. Army soldiers, suggest that a combination of ergonomic and individual/organizational psychosocial factors may play a role in the development, exacerbation, and maintenance of work disability. Future research that identifies specific job factors contributing to increased back disability risk should assist in the development of empirically based work site prevention programs to improve musculoskeletal health and readiness.

Absenteeism↗
PubMed2000

Low back pain in general practice: reported management and reasons for not adhering to the guidelines in The Netherlands.

BACKGROUND: Although guidelines for the management of low back pain have been published in the past decade, there is potential for further improvement in back pain care. AIM: To document the management of non-specific low back pain by general practitioners (GPs) in the Netherlands, to determine how this management of care is related to patient and physician factors, and to explore possible reasons for not adhering to the guidelines. METHOD: A prospective study was set up in which 57 GPs in 30 general practices completed a computerised questionnaire after each consultation for low back pain during a four-month period. RESULTS: Of 1640 back pain contacts, 1180 referred to non-specific low back pain. Diagnostic tests were ordered in 2% of first consultations and in 7% of follow-up consultations within one episode. The advice to stay active despite pain was given in 76% and 69% of these cases respectively. Patients were prescribed an analgesic in 53% and 41% of cases respectively (mainly NSAIDs [80%]). Patients were referred to a physiotherapist in 22% of first and in 50% of follow-up consultations. Older patients were physically examined less often, prescribed analgesics more often, and were told less often that staying active could benefit them. The advice to remain active was omitted more often when symptoms lasted longer. Only a small part of the variance in management was accounted for by patient characteristics or by differences between practices. CONCLUSION: The management of low back pain met the guidelines to a large extent. Management decisions were often related to characteristics in which the guidelines lack differentiation. Important reasons for non-adherence were perceived patients' preferences. Further implementation of guidelines will be difficult unless doctors' and patients' views are more explicitly known.

Adolescent↗
PubMed2000

[Local and general rest in the treatment of common low back pain].

The routine prescription of rest for patients with common low back pain is now widely questioned. Local rest using lumbar corsets and back supports is useful only in case of acute or extreme low back pain, in particular if trauma is involved. In chronic low back pain, such support should be used only to facilitate pursuit of an at-risk professional activity. In acute low back pain, general rest should be indicated by the intensity of pain and not prescribed as a treatment itself. General prolonged rest in acute low back pain has now been demonstrated to entail nefarious long-term effects. In the patient with chronic low back pain, general rest will favour loss of physical condition and exacerbate the difficulties socio-professional rehabilitation.

Acute Disease↗
PubMed2002

["The body-consciousness in school"--a back pain-school].

INTRODUCTION: The aim of the present study was to demonstrate the extent of back pain in a school population and to evaluate if it was possible to minimize the number of complaints by increasing the body-consciousness in school children and education of pupils, teachers, and parents. MATERIAL AND METHODS: A prospective, controlled interventional study in two comparable schools with pupils from pre-school up to and including ninth level. All pupils and their parents completed a questionnaire before and after the intervention. RESULTS: The share of pupils with back pain increased in the older age groups, whereas the frequency of physical activity decreased. Pupils who disliked going to school had more frequently back pain than pupils who liked going to school, and pupils who liked going to school were more physically active. There was a correlation between the back pain of the pupils and that of their parents. The intervention did not have any effect on the back pain of the pupils or their parents. DISCUSSION: There was no significant effect of the intervention, which might be explained by the relatively short time of implementation and unexpected practical problems at the school. The base-line values showed a correlation between age and back pain and between back pain and "do not like going to school". The frequency of physical activity decreased in the older age groups. Physically active pupils liked best going to school. There is a uniformity in the complaints of the parents and children and their reaction to the symptoms.

Adolescent↗
PubMed2003

Glomus tumor as a cause of chronic low back pain: case report.

STUDY DESIGN: A case of chronic low back pain caused by a glomus tumor that persisted more than 30 years is presented. OBJECTIVE: To emphasize the need to consider skin tumors in the differential diagnosis of low back pain. SUMMARY OF BACKGROUND DATA: Chronic low back pain can be caused by a myriad of factors. There are six relatively common skin tumors, which present as painful lesions. As seen in the reported case, if they occur in the lumbar region, they can cause low back pain. METHODS: A subject with low back pain underwent an excision biopsy of a localized area of tenderness where his symptoms were reproduced when light pressure was applied. RESULTS: Histology confirmed that a glomus tumor accounted for the subject's pain. CONCLUSIONS: Painful skin tumors may cause low back pain and need to be considered in the differential diagnosis of chronic low back pain.

Chronic Disease↗
PubMed2002

[Lower back pain in truck drivers working in plateau areas and its prevention].

OBJECTIVE: To investigate the epidemiological characteristics of lower back pain of truck drivers in plateau areas with an analysis of the causes and evaluated the effects of the protective measures. METHODS: The self-reported lower back symptom was investigated by questionnaire in 1,132 male drivers in plateau areas. Vibration of the driver lumbar back was measured real time with or without wearing corset. Study the effect of the special corset for drivers and the massage on back by self-control design of big sample intervention experiments. RESULTS: The prevalence of lower back pain of drivers in plateau areas was 86.1%. High level of its prevalence is due to many factors. Special corset for drivers and massage on back by themselves can reduce the degree of the pain. CONCLUSION: Driving in plateau areas is a special occupational work with high level of prevalence of lower back pain which can be prevented.

Automobile Driving↗
PubMed2004

Correlation of nerve root pain with dermatomal sensory threshold and back pain with spinal movement in single level lumbar spondylosis.

We studied 27 patients with low back pain and unilateral L5 or S1 spinal nerve root pain. Significant radiological changes were restricted to the symptomatic root level, when compared with controls. Low back and leg pain were graded on a visual analogue scale. Dermatomal quantitative sensory tests revealed significant elevations of warm, cool and touch perception thresholds in the affected dermatome, compared with controls. These elevations correlated with root pain (warm v L5 root pain; r = 0.88, p < 0.0001), but not with back pain. Low back pain correlated with restriction of anteroposterior spinal flexion (p = 0.02), but not with leg pain. A subset of 16 patients underwent decompressive surgery with improvement of pain scores, sensory thresholds and spinal mobility. A further 14 patients with back pain, multilevel nerve root symptoms and radiological changes were also studied. The only correlation found was of low back pain with spinal movement (p < 0.002). We conclude that, in patients with single level disease, dermatomal sensory threshold elevation and restriction of spinal movement are independent correlates of sciatica and low back pain.

Adult↗
PubMed2004

One-hour lecture/demo produces mastery level back safety transfer skills self-efficacy in randomized comparisons among hospital nurses.

More than 1/3 of back injuries among nurses result from patient transfers. So, a rigorous between-subjects quasi-experimental methodology having broad clinical applicability was developed to evaluate the effects of a one-hour didactic back safety and patient transfer training lecture/demonstration upon 42 recently hired hospital nurses. The design implemented independent random samples including independent control groups, though practical constraints required all 42 to participate in the training. Training effects were assessed for each of three back safety transfer skill self-efficacy measures and their composite total self-efficacy score. Four monthly training sessions, each serving different nurses, achieved significant and substantial impacts on both composite total back safety procedure self-efficacy (where effect sizes ranged from approximately 0.8 to 1.8 standard deviations) and on each individual back safety transfer skill self-efficacy measure. After training, 85% to 100% of the nurses rated their back safety procedure self-efficacy within three points of the maximum composite total of 30 on the self-efficacy scale. Results may help improve nursing services and identify training strategies to reduce healthcare worker back injuries.

Analysis of Variance↗
PubMed2005

Aetiology of low back pain in Mulago Hospital, Uganda.

BACKGROUND: Low back pain exists in epidemic proportions in the western world and is on the increase. Its cause is mostly nonspecific. Not much is known about it in the developing world because the data is scanty. This study was set out to investigate the possible causes of low back pain and prevalence. OBJECTIVE: To establish the likely causes of low back pain among patients seen in the out patient department, Mulago Hospital, Uganda. METHODS: 204 patients were enrolled out of 1033 general patients who were present to the out patient referral hospital orthopedic clinic. All the 204 were referred patients with low back pain as the chief complaint. They were subjected to a questionnaire, which included history taking, a physical examination and investigations. Data was entered using Epi info soft ware and analyzed using SPSS. RESULTS: The prevalence was 20%. The mean age was 47 years 10 months. The majority, 62.3% of patients had mechanical or simple back pain with no definable patho-anatomic causative factor (non-specific). 19.1% had nerve root compression due to prolapsed intervertebral discs. 17.2% had serious spinal pathology due to tuberculosis, brucellosis, fractures and degenerative changes. For 3 patients (1.5%) the cause was not determined. CONCLUSION: The findings indicate that low back pain of non-specific aetiology is the commonest cause of back pain. The precise aetiology of this large indefinite entity warrant further study.

Cross-Sectional Studies↗
PubMed2005

[Knowledge, practice and attitudes to back pain among doctors, physiotherapists and chiropractors].

BACKGROUND: In Norway, only doctors, physiotherapists and chiropractors are authorised to examine and treat patients suffering from low back pain. This study compares knowledge, attitudes and practice among these professional groups. MATERIAL AND METHODS: All 1105 doctors, physiotherapists and chiropractors in three Norwegian counties received a questionnaire with one section about knowledge, one about the action that respondents would recommend for various diagnoses, and one focused on attitudes towards back pain. RESULTS AND INTERPRETATIONS: The chiropractors had the largest number of back pain patients in their practice and expressed the highest degree of professional interest in the field. We found no essential differences regarding knowledge between the groups. 77 % of the physiotherapists would refer acute sciatica to a doctor, while only 24 % of the chiropractors would do so. 65 % of the doctors and 10 % of the chiropractors would refer a chronic low back pain patient for physical therapy. Doctors and physiotherapists have a longstanding tradition of mutual cooperation, while chiropractors only seldom seem to refer to other care providers. One in five doctors and chiropractors, and 13 % of the physiotherapists, refer an acute unspecific low back pain to plain X-ray, which is not in accordance with the guidelines. Very few health care providers regarded low back pain as disabling. There are also few professionals who believe it possible to find an exact cause for the back pain in the individual patient.

Attitude of Health Personnel↗
PubMed2005

[Epidemiological characteristics of low back pain in selected sample of rehabilitation centre "Reumal" in Fojnica].

Low back pain, with or without propagation to lower extremities, still remains challenge not only for therapy but as diagnostic entity as well. This is the reason why literature is regularly refreshed with new epidemiological studies of low back pain. Six years retrospective study included 55.725 patients rehabilitated in Rehabilitation centre "Reumal" in Fojnica, from January 1997 to December 2002. From this sample it has been isolated 12.296 patients with diagnosis referred to low back pain, in order to get certain epidemiological parameters of low back pain, as: intrahospital prevalence, gender and age overview, overview of diagnostic entities referred to low back pain and their relationship to gender. Total prevalence of low back pain was 22,6 %, ranging from 17,8 % to 28,6 % by years. This epidemiological parameter of low back pain, as well as others, correlate with data of other studies.

Adult↗
PubMed2005

[Relation of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang].

OBJECTIVE: To study on relation of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang. METHODS: With analysis of origin of Back-shu points of zang- and fu-organs and their indications, the relation of Back-shu points with the incidental and fundamental aspects, theory of qi-flow, and the characteristics of the parts of indications of acupoints reflected by Back-shu points, relations of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang were studied. RESULTS: Indications of Back-shu points, a group of acupoints on the circulation route of The Foot-Taiyang Channel, are not found in the channel, which is difficult to explain from twelve channel theory. However, the relation of the incidental and fundamental aspects, theory of qi-flow, and the characteristics of the parts of indications of acupoints with the indications, and the branches of channels presented due to channel tropism of acupoints, etc. contribute to explain the indications of Back-shu points for diseases and syndromes of five zang-organs and six fu-organs. CONCLUSION: The relation of indications of acupoints with disease groups and circulation route of channels can not be discussed simply by Miraculous Pivot . Channels.

Acupuncture Points↗
PubMed2006

Predicting persistent disabling low back pain in general practice: a prospective cohort study.

BACKGROUND: Patients may adopt active and/or passive coping strategies in response to pain. However, it is not known whether these strategies may also precede the onset of chronic symptoms and, if so, whether they are independent predictors of prognosis. AIM: To examine, in patients with low back pain in general practice, the prognostic value of active and passive coping styles, in the context of baseline levels of pain, disability and pain duration. DESIGN OF STUDY: Prospective cohort study. SETTING: Nine general practices in north west England. METHOD: Patients consulting their GP with a new episode of low back pain were recruited to the study. Information on coping styles, pain severity, disability, duration, and a brief history of other chronic pain symptoms was recorded using a self-completion postal questionnaire. Participants were then sent a follow-up questionnaire, 3 months after their initial consultation, to assess the occurrence of low back pain. The primary outcome was persistent disabling low back pain, that is, low back pain at 3-month follow-up self-rated as >or=20 mm on a 100 mm visual analogue scale, and >or=5 on the Roland and Morris Disability Questionnaire. RESULTS: A total of 974 patients took part in the baseline survey, of whom 922 (95%) completed a follow-up questionnaire; 363 individuals (39%) reported persistent disabling pain at follow-up. Persons who reported high levels of passive coping experienced a threefold increase in the risk of persistent disabling low back pain (relative risk [RR] = 3.0; 95% confidence interval [CI] = 2.3 to 4.0). In contrast, active coping was associated with neither an increase nor a decrease in the risk of a poor prognosis. After adjusting for baseline pain severity, disability, and other measures of pain and pain history, persons who reported a high passive coping score were still at 50% increased risk of a poor outcome (RR = 1.5; 95% CI = 1.1 to 2.0). CONCLUSION: Patients who report passive coping strategies experience a significant increase in the risk of persistent symptoms. Further, this risk persists after controlling for initial pain severity and disability. The identification of this low back pain subgroup may help target future treatments to those at greatest risk of a poor outcome.

Adaptation, Psychological↗
PubMed1991

Failed back surgery syndrome.

The failed back or postlaminectomy syndrome is obviously multidimensional. Failure of therapy may result from structural abnormalities in the back, psychosocial influences, or a combination of both. The causes of back pain are largely unknown. Correlations with diagnostic studies are uncertain. The lack of precise diagnoses is reflected in a multiplicity of nonspecific treatments, mostly of unproven value. Our current disability-litigation system adds greatly to the problem. Patients are rewarded for nonfunction. Some physicians become advocates for patients, others for insurance carriers and employers. Decisions concerning appropriate treatment are often made by patients, attorneys, the disability determination system, employers, and judges for extraneous reasons, which include financial gain or personal bias and often reflect lack of current information. Even when correct decisions are made, there is a lack of adequate programs for diagnosis and comprehensive treatment of these individuals. The failed back syndrome is not likely to disappear quickly. Large numbers of these patients require care. The best available evaluation includes thorough, but not overly minute investigation using the best current imaging techniques. These studies combined with the history and physical examination should provide a reasonably accurate assessment of the patient's condition. Concomitant evaluation of psychosocial issues is mandatory, and those who treat these patients without understanding the importance of the various comorbidities discussed are likely to be detrimental. Reparative surgery has real, but limited use. Nerve root compression and instability are the only two conditions demonstrated to be correctable at the present time. However, even when a potentially remediable lesion is found, these patients should undergo a reasonable attempt at physical rehabilitation with attention to both local factors and general function. The best data available today suggest that most of the patients suffering from failed back syndrome are incapacitated by psychiatric, psychologic, and social/vocational factors, which relate to the back complaint only indirectly. Those currently suffering from this problem can be best treated by comprehensive programs that address these complex psychosocial issues. New additions to this category can be reduced by rigorous attention to physical abnormalities, so that surgery is undertaken only for clear indications, and appreciation of the importance of the psychologic aspects of disability from low back pain. The smaller group suffering principally from physical abnormalities can be improved by reparative surgery or pain-relieving procedures if intensive conservative rehabilitation efforts fail. All surgical procedures fail occasionally, and as long as there is a need for reparative surgery, some patients will fail to benefit or be worsened by the procedures.(ABSTRACT TRUNCATED AT 400 WORDS)

Back Pain↗
PubMed1990

Anthropometric and clinical measures as predictors of back pain complaints in industry: a prospective study.

A prospective, longitudinal investigation was conducted to investigate anthropometric and clinical examination measures as predictors of future back pain reports in industry. Associations between these measures and a history of back problems were examined as well. Participants in the study included 3,020 aircraft manufacturing employees who underwent an examination and then were tracked for greater than 4 years for subsequent back pain reports. Back symptoms elicited on straight leg raising (SLR) was the measure most significantly associated with subsequent back pain reporting among both men and women (p less than 0.0001). The only variables to add predictive value in addition to back pain on SLR were age and weight in women, and history of back problems and age in men.

Adult↗