Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Back”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,621 records · Page 90Linked to original sources
PubMed1993

Body composition, endurance, strength, cross-sectional area, and density of MM erector spinae in men with and without low back pain.

Thirty-six 45-55-year-old men with healthy low backs were studied with respect to body composition, isokinetic and isometric trunk strength, trunk muscle endurance, and cross-sectional area and radiological density of mm erector spinae. Results were compared to those of men in the same age group with intermittent low back pain (LBP) (n = 91) and with chronic LBP (n = 21). The back healthy group was significantly stronger and had longer trunk muscle endurance times than men with chronic LBP. Men with intermittent LBP had strength and endurance values in between the back healthy and chronic groups. There were no significant differences between any of the groups with respect to body composition and cross-sectional area of mm erector spinae. Radiological density for mm erector spinae was significantly decreased in the chronic LBP group compared to the back healthy and intermittent LBP groups. The deconditioning syndrome and its relationship to intermittent and chronic LBP is discussed.

Back↗
PubMed1997

Decreasing disability in chronic back pain through aggressive spine rehabilitation.

This paper discusses specific techniques for rehabilitation of chronic low back pain through aggressive physical therapy with behavioral support. The rationale for approaching the outcome dimensions of impairments in back function and pain-related disability as opposed to chronic pain symptoms is explained. This approach requires that impairments in back function are systematically identified through the quantification of trunk flexibility, straight leg raising, back extensor strength, lifting ability, and endurance. The described treatment approach focuses on eliminating those impairments through aggressive, quota-based exercise and is usually completed within 8 weeks. It requires only a modest amount of space and equipment. Useful behavioral techniques for extinguishing pain behaviors, lessening pain beliefs, and for promoting wellness are described. Results from a treatment program using these techniques demonstrate normal back function and reduced disability for a majority of treated persons. Applying such a program to the VA population is an important challenge.

Back Pain↗
PubMed2000

Lean body mass and body fat distribution in participants with chronic low back pain.

BACKGROUND: Loss of muscle mass and central obesity progress with aging, but the effect of muscle loss on chronic low back pain has not been precisely evaluated. METHODS: Three hundred thirty Japanese persons aged 45 to 69 years, with a complaint of low back pain for longer than 3 months (n = 203) and age- and sex-matched healthy control subjects (n = 127), were enrolled in this study. Participants with chronic low back pain were classified into the following groups: (1) women with a positive straight leg raise test result, (2) women with a negative straight leg raise test result, (3) men with a positive straight leg raise test result, and (4) men with a negative straight leg raise test result. Controls were classified by sex into a female and a male group. Anthropometric data, consisting of body mass index, percentage body fat, waist-hip ratio, and lean body mass of the upper extremities, trunk, and lower extremities divided by body weight, were measured in participants with low back pain, and the results were compared with those of controls. RESULTS: The waist-hip ratio in women with a negative straight leg raise test result was significantly higher than those in the female control group (P<.001) and in the women with a positive straight leg raise test result (P =.04). The lean body mass of the trunk and lower extremities divided by body weight of women with a negative straight leg raise test result was significantly lower than that of female controls (P =.03 for the trunk and P<.001 for the lower extremities). However, no significant differences were detected between the female negative straight leg raise test result group and the female control group for lean body mass of the upper extremities divided by body weight or body mass index. There were no significant differences in anthropometric data between the male test and control groups or between the female positive straight leg raise test result group and the female control group. CONCLUSION: Trunk and lower extremity loss of muscle mass and central obesity may be risk factors for chronic low back pain without a positive straight leg raise test result in women aged 45 to 69 years. Arch Intern Med. 2000;160:3265-3269.

Adipose Tissue↗
PubMed2001

Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain.

BACKGROUND: Because the value of popular forms of alternative care for chronic back pain remains uncertain, we compared the effectiveness of acupuncture, therapeutic massage, and self-care education for persistent back pain. METHODS: We randomized 262 patients aged 20 to 70 years who had persistent back pain to receive Traditional Chinese Medical acupuncture (n = 94), therapeutic massage (n = 78), or self-care educational materials (n = 90). Up to 10 massage or acupuncture visits were permitted over 10 weeks. Symptoms (0-10 scale) and dysfunction (0-23 scale) were assessed by telephone interviewers masked to treatment group. Follow-up was available for 95% of patients after 4, 10, and 52 weeks, and none withdrew for adverse effects. RESULTS: Treatment groups were compared after adjustment for prerandomization covariates using an intent-to-treat analysis. At 10 weeks, massage was superior to self-care on the symptom scale (3.41 vs 4.71, respectively; P =.01) and the disability scale (5.88 vs 8.92, respectively; P<.001). Massage was also superior to acupuncture on the disability scale (5.89 vs 8.25, respectively; P =.01). After 1 year, massage was not better than self-care but was better than acupuncture (symptom scale: 3.08 vs 4.74, respectively; P =.002; dysfunction scale: 6.29 vs 8.21, respectively; P =.05). The massage group used the least medications (P<.05) and had the lowest costs of subsequent care. CONCLUSIONS: Therapeutic massage was effective for persistent low back pain, apparently providing long-lasting benefits. Traditional Chinese Medical acupuncture was relatively ineffective. Massage might be an effective alternative to conventional medical care for persistent back pain.

Acupuncture Therapy↗
PubMed1977

Electromyographic biofeedback for pain related to muscle tension. A study of tension headache, back, and jaw pain.

We review the literature on the application of electromyographic (EMG) biofeedback to tension-related headaches, back and shoulder pain, and temporomandibular joint (TMJ) pain and present clinical treatment data on 18 patients with tension headaches, eight patients with back and shoulder pain, and six patients with TMJ pain. Electromyographic tension levels declined in all groups of patients; pain declined significantly in 12 of 18 patients with tension headaches and one of eight back pain patients, and decreased slightly in three headache patients, three back and shoulder pain patients, and two patients with TMJ pain. Conclusions suggest that EMG biofeedback is generally more effective in treating tension headaches, but much less effective in the treatment of back, shoulder, or jaw pain, although the numbers of patients are small in the latter two groups.

Adolescent↗
PubMed2003

Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial.

CONTEXT: Faster magnetic resonance imaging (MRI) scanning has made MRI a potential cost-effective replacement for radiographs for patients with low back pain. However, whether rapid MRI scanning results in better patient outcomes than radiographic evaluation or a cost-effective alternative is unknown. OBJECTIVE: To determine the clinical and economic consequences of replacing spine radiographs with rapid MRI for primary care patients. DESIGN, SETTING, AND PATIENTS: Randomized controlled trial of 380 patients aged 18 years or older whose primary physicians had ordered that their low back pain be evaluated by radiographs. The patients were recruited between November 1998 and June 2000 from 1 of 4 imaging centers in the Seattle, Wash, area: a university-based teaching program, a nonuniversity-based teaching program, and 2 private clinics. INTERVENTION: Patients were randomly assigned to receive lumbar spine evaluation by rapid MRI or by radiograph. MAIN OUTCOME MEASURES: Back-related disability measured by the modified Roland questionnaire. Secondary outcomes included Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), pain, preference scores, satisfaction, and costs. RESULTS: At 12 months, primary outcomes of functional disability were obtained from 337 (89%) of the 380 patients enrolled. The mean back-related disability modified Roland score for the 170 patients assigned to the radiograph evaluation group was 8.75 vs 9.34 for the 167 patients assigned the rapid MRI evaluation group (mean difference, -0.59; 95% CI, -1.69 to 0.87). The mean differences in the secondary outcomes were not statistically significant : pain bothersomeness (0.07; 95% CI -0.88 to 1.22), pain frequency (0.12; 95% CI, -0.69 to 1.37), and SF-36 subscales of bodily pain (1.25; 95% CI, -4.46 to 4.96), and physical functioning (2.73, 95% CI -4.09 to 6.22). Ten patients in the rapid MRI group vs 4 in the radiograph group had lumbar spine operations (risk difference, 0.34; 95% CI, -0.06 to 0.73). The rapid MRI strategy had a mean cost of 2380 dollars vs 2059 dollars for the radiograph strategy (mean difference, 321 dollars; 95% CI, -1100 to 458). CONCLUSIONS: Rapid MRIs and radiographs resulted in nearly identical outcomes for primary care patients with low back pain. Although physicians and patients preferred the rapid MRI, substituting rapid MRI for radiographic evaluations in the primary care setting may offer little additional benefit to patients, and it may increase the costs of care because of the increased number of spine operations that patients are likely to undergo.

Activities of Daily Living↗
PubMed1998

Low back pain: predictors of absenteeism, residual symptoms, functional impairment, and medical costs in Oregon workers' compensation recipients.

BACKGROUND: Wide variations in disability duration and magnitude have been noted among recipients of workers' compensation for low back pain. Findings from recent studies have indicated that inclusion of a broad array of variables (i.e., physical, occupation, social, economic) is needed to understand differences in workers' responses to occupational low back pain. METHODS: Workers' compensation and questionnaire data from 340 Oregon workers with low back claims were merged to develop multivariate models predicting: (1) absenteeism days, (2) residual symptoms, (3) functional impairment, and (4) medical costs. RESULTS: Forty-two percent of the variation in low back symptoms was explained by: discontinuing physical fitness activities post-injury (beta = -.419), self-reported low energy/high fatigue (beta = -.227), poorer general health (beta = .137), and attorney involvement in claim (beta = .117), (adjusted R2 = .418, p < 0.001). Survival curves revealed significantly longer claim durations among workers who discontinued physical fitness activities post-injury, compared with workers who did not; these differences remained significant even after controlling for severity of the initial injury. CONCLUSION: Continuation of physical fitness activities during the recovery process was found to be a significant predictor in three of four regression models, providing evidence on behalf of a relationship between fitness and positive health outcomes. However, it was not possible to clearly differentiate pre-morbid from post-injury fitness, nor to determine if this relationship was due to a therapeutic effect on the back, the general restorative benefits of remaining active, or represents a proxy variable for workers' self-care efforts during recovery.

Absenteeism↗
PubMed2006

Herbal medicine for low back pain.

BACKGROUND: Low-back pain is a common condition and a substantial economic burden in industrialized societies. A large proportion of patients with chronic low-back pain use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in low-back pain. OBJECTIVES: To determine the effectiveness of herbal medicine for non-specific low-back pain. SEARCH STRATEGY: We searched the following electronic databases: Cochrane Complementary Medicine Field Trials Register (Issue 3, 2005), MEDLINE (1966 to July 2005), EMBASE (1980 to July 2005); checked reference lists in review articles, guidelines and retrieved trials; and personally contacted individuals with expertise in this very specialized area. SELECTION CRITERIA: We included randomized controlled trials, examining adults (over 18 years of age) suffering from acute, sub-acute or chronic non-specific low-back pain. The interventions were herbal medicines, defined as plants that are used for medicinal purposes in any form. Primary outcome measures were pain and function. DATA COLLECTION AND ANALYSIS: Two authors (JJG & MVT) conducted the database searches. One author contacted content experts and acquired relevant citations. Full references and abstracts of the identified studies were downloaded. A hard copy was retrieved for final inclusion decisions. Methodological quality and clinical relevance were assessed separately by two individuals. Disagreements were resolved by consensus. MAIN RESULTS: Ten trials were included in this review. Two high quality trials examining the effects of Harpagophytum Procumbens (Devil's Claw) found strong evidence that daily doses standardized to 50 mg or 100 mg harpagoside were better than placebo for short-term improvements in pain and rescue medication. Another high quality trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib (Vioxx). Two trials examining the effects of Salix Alba (White Willow Bark) found moderate evidence that daily doses standardized to 120 mg or 240 mg salicin were better than placebo for short-term improvements in pain and rescue medication. An additional trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib. Three low quality trials on Capsicum Frutescens (Cayenne), examining various topical preparations, found moderate evidence that Capsicum Frutescens produced more favourable results than placebo and one trial found equivalence to a homeopathic ointment. AUTHORS' CONCLUSIONS: Harpagophytum Procumbens, Salix Alba and Capsicum Frutescens seem to reduce pain more than placebo. Additional trials testing these herbal medicines against standard treatments are needed. The quality of reporting in these trials was generally poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions.

Adult↗
PubMed1995

Back pain among workers in the United States: national estimates and workers at high risk.

Back pain accounts for about one fourth of workers' compensation claims in the United States. The Occupational Health Supplement to the 1988 National Health Interview Survey provided an opportunity to assess the scope of this problem. The 30,074 respondents who worked in the 12 months before the interview were defined as "workers", and those with back pain every day for a week or more during that period were defined as "cases." A weighting factor was applied to the answers to derive national estimates. In 1988, about 22.4 million back pain cases (prevalence 17.6%) were responsible for 149.1 million lost workdays; 65% of cases were attributable to occupational activities. For back pain attributed to activities at work, the risk was highest for construction laborers among males (prevalence 22.6%) and nursing aides among females (18.8%). Our analyses show that back pain is a major cause of morbidity and lost production for U.S. workers and identifies previously unrecognized high risk occupations, such as carpenters, automobile mechanics, maids, janitors, and hairdressers, for future research and prevention.

Adult↗
PubMed2003

Lumbar lordosis: study of patients with and without low back pain.

We used magnetic resonance imaging (MRI) to assess lumbar lordosis in 27 patients with low back pain and 19 patients and 10 volunteers with no known back pain. Our study aimed to investigate whether lordosis changes with age and is reduced in those with low back pain. Although our results confirm known observations that lumbar lordosis is more prominent in women (P < 0.01) and those with a higher body mass index (P < 0.04), we were unable to demonstrate any significant variation in lordosis with age. Nor could we demonstrate any difference in the degree of lordosis among women with or without back pain. Men with low back pain tended to have a less prominent lordosis, but this difference did not reach statistical significance. Therefore, a 'reduced lumbar lordosis' should be regarded as a very weak clinical sign.

Adult↗
PubMed1988

Spinal deformity and back surface asymmetry in idiopathic scoliosis.

Stereo radiography and stereotopography were used to record simultaneously the three-dimensional spinal and back surface shape of 141 patients with a clinical diagnosis of adolescent onset idiopathic scoliosis. Radiography confirmed 80 patients with single lateral curves (Cobb angle 5-87 degrees); 59 with double curves (Cobb angle 5-61 degrees), and two patients with triple curves. Orientation of each vertebra was measured by the lateral deviation from the spinal axis and the axial rotation. For each curve detected, the Cobb angle, the maximum deviation, the maximum axial rotation, and the sagittal plane curvature was measured. Topographic data were used to generate a profile of a cross-section through the back of each vertebral level. This section was characterized by its axial rotation, deviation of its midpoint from the spinal axis, and area symmetry about the midpoint. Maximum values of these measurements in the region of each radiographic scoliosis curve were noted. Regression and correlation analysis showed (for each curve) a high correlation of apical vertebral lateral deviation with back surface axial rotation (r = 0.79) and with vertebral axial rotation (r = 0.79). The back surface rotation was less than vertebral rotation in magnitude, however, by a mean factor of 0.55. The measurement of the back surface asymmetry that gave the highest correlation with the skeletal deformity was the axial rotation. Relationships between skeletal and surface measures were similar for curves in thoracic and lumbar regions and for patients with single and double curves. There is potential for clinical application of surface measurement techniques to prescription of orthoses and monitoring of changes due to progression or treatment.

Adolescent↗
PubMed2003

Evaluation and treatment of low back pain: an evidence-based approach to clinical care.

Low back pain is a common reason for patient visits to a health care provider. For most patients, low back symptoms are nonspecific, meaning that the pain is localized to the back or buttocks and is due to a presumed musculoligamentous process. For patients with radicular leg symptoms, a precise etiology is more commonly identified. The history and physical examination usually provide clues to the uncommon but potentially serious causes of low back pain, as well as to those patients at risk for prolonged recovery. Diagnostic testing should not be a routine part of the initial evaluation, but used selectively based upon the history, examination, and initial treatment response. For patients without significant neurological impairment, initial treatments should include activity modification, nonnarcotic analgesics, and education. For patients whose symptoms are not improving over 2 to 4 weeks, referral for physical treatments is appropriate. A variety of therapeutic options of limited or unproven benefit are available for patients with radicular leg symptoms or chronic low back pain. Patients with radicular pain and little or no neurological findings should receive conservative treatment, but elective surgery is appropriate for those with nerve root compression who are unresponsive to conservative therapy.

Evidence-Based Medicine↗
PubMed2000

Effects of a three-month therapeutic exercise programme on flexibility in subjects with low back pain.

BACKGROUND AND PURPOSE: Spinal and muscle flexibility have been studied intensively and used clinically as outcome measurements in the rehabilitation of subjects with low back pain. The results of previous studies are contradictory and there is a lack of longitudinal data on the effects of long term therapeutic exercise on flexibility. METHOD: A controlled experimental study was conducted to determine the effects of progressive therapeutic exercise on spinal and muscle flexibility. Eighty-six chronic low back pain subjects fulfilled the inclusion criteria and were divided into three study groups: (1) intensive training group, (2) home exercise group and (3) control group. The intervention period lasted three months and measurements were performed at both the beginning of the study and immediately after intervention. Follow-up measurements were carried out six and 12 months after baseline. Spinal flexibility was measured with lumbar flexion, extension, spinal lateral flexion and rotation, and muscle flexibility was measured with measurements of erector spinae, hamstring and iliopsoas muscles. Also self-reported outcomes of the Oswestry Index and Borg Scale--Back Pain Intensity were used. Associations between change (pre- to post-treatment) were determined for the dependent variables. RESULTS: The results showed no correlation between flexibility, the Oswestry Index or back pain intensity. After the first three-month period lumbar flexion, extension and spinal rotation decreased among all subjects. Spinal rotation and erector spinae muscle flexibility improved significantly with intensive training. At the nine-month follow-up, erector spine flexibility was still greater than at baseline. Hamstring flexibility increased among the intensive training and home exercise groups from pre- to post-intervention. However, the degree of hamstring flexibility gained during training was subsequently lost following the period without programmed exercise in both training groups. Self-reported outcome variables showed positive changes among the three study groups after the completion of intervention period, but these changes were only able to be maintained during subsequent follow-ups for the intensive training and home exercise groups. CONCLUSIONS: The findings suggest that flexibility does not play an important role in coping with chronic low back pain for subjects whose functional limitations are not severe. Also, it appears that the achieved gains in spinal and muscle flexibility may not be able to be maintained without continued exercise.

Case-Control Studies↗
PubMed2001

Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain.

BACKGROUND AND PURPOSE: Walking is an important functional activity and the shuttle walking test has been shown to be a useful test for patients with chronic airways obstruction and heart failure. The test has been used in low back pain research over recent years and has increasingly been used as an outcome measure to investigate treatment efficacy in patients with low back pain. The aim of the present study was to determine the reliability and responsiveness of the shuttle walking test within a group of patients with low back pain (with or without sciatica). METHOD: Reliability of the shuttle walking test was determined on a group of patients with low back pain (n = 44) using the Bland and Altman (1986) limits of agreement and the intraclass correlation coefficient (ICC). Responsiveness was assessed using the standardized effect size. The mean distance walked within a patient population (n = 337) was compared with an age- and sex-matched group of healthy subjects (n = 122). RESULTS: The shuttle walking test obtained an ICC score of 0.99, whereas the limits of agreement test gave a mean difference of 2.5 m with upper and lower limits of agreement of 52 m and -47 m, respectively. Patients undertaking fitness training reached an effect size of 1.2 compared to a control group of 0.23 and 0.94 for a group undergoing various orthopaedic treatments. CONCLUSIONS: The present study has shown that the shuttle walking test is a reliable and responsive test within a group of patients with low back pain, with or without sciatica. It is simple to administer and provides a quick method of measuring one aspect of a patient's physical function.

Adult↗
PubMed1996

Sense of coherence and outcome of low-back surgery: 5-year follow-up of 80 patients.

Eighty adult patients, 33 men and 47 women, mean age 46 years (SD 11.8, range 19-74 years), were evaluated 5 years after low-back surgery. The mean duration of symptoms before operation was 8.7 (SD 7.1) years. The purpose was to evaluate the 5-year outcome of low-back surgery, to find the best predictors for the outcome, and to find out if a correlation exists between the patient's sense of coherence and the outcome of low-back surgery. The mean Oswestry pain index for the whole group of patients improved from 3.8 to 2.7 (P < 0.001). The greatest improvement in pain was found in the group aged 35-50 years. In those over 50 years old, pain improved significantly more in women than men. Regarding walking ability, the mean Oswestry gait index for the whole group improved from 3.0 to 1.9 (P < 0.001), with men over 50 years old achieving the greatest improvement in their walking. The mean Oswestry total index for the whole group was 41% before surgery, reflecting severe disability, and 25% at follow-up, reflecting moderate disability (P < 0.001). There was no difference between the mean values for men and women. Patients who had undergone several previous operations fared less well in the Oswestry total index, though their improvement was still significant (P < 0.05). The postoperative Oswestry total index values correlated significantly with the sense of coherence (SOC) scale values (r = -0.23, P < 0.05). In all patients, the Oswestry total index before the index operation is suggested to be a predictor of the final outcome. In multiple regression analysis, the number of previous operations and the preoperatively recorded Oswestry total index appeared to be the best predictors for outcome of low-back surgery. We also found that the SOC scale correlated significantly with the Oswestry total index and seems to provide a possible explanation of ability to cope with the disability and pain associated with low-back disorders.

Adaptation, Psychological↗
PubMed1994

The incidence of back pain and headache among Swedish school children.

Musculoskeletal pain is exceedingly common in young adults. With the aim of studying these symptoms in schoolchildren, a questionnaire survey was carried out among children 8, 11, 13 and 17 years old. The prevalence of back pain and headaches in 1,245 schoolchildren was studied. Twenty-nine per cent of the students reported back pain and 48% headache. In all age groups studied, both back pain and headaches were more common among girls than boys. Girls also reported more frequent symptoms than boys. In a longitudinal study 471 schoolchildren were asked a second time 2 years later. Nine per cent reported back pain and 30% headache in both surveys. Five per cent reported both back pain and headache on both occasions. Despite the reported symptoms most of the pupils did not report health problems. However, pupils with reported pain on both occasions may constitute a risk group for future chronic pain. There were statistically significant relationships between social, psychological and emotional factors and reported symptoms. No relationship between physical factors and reported symptoms were noted. The observed relationships are not proof of causal relations but did indicate areas of problems which make interventions targeting pupils at risk an appropriate measure.

Adolescent↗
PubMed1996

Sense of coherence and outcome of anterior low-back fusion. A 5- to 13-year follow-up of 85 patients.

Eighty-five patients were followed up for more than 5 years after an anterior low-back fusion which was performed for a chronically painful low-back condition. The mean age of the patients at the time of the index operation was 35 years, the mean duration of their symptoms was 8 years, and 50 (59%) had undergone previous low-back surgery. Preoperatively the patients were on average severely disabled according to the Oswestry scale, and the self-rated improvement at the follow-up on average 7.4 years after surgery was significant, the mean index being 24%. In 29 (34%) patients, the Oswestry index was 10% or below, reflecting none or very little discomfort as a result of the surgery. In all age groups, women had better results than men. The best outcome was found in patients with no previous low-back surgery. Half of the patients returned to work. Thirteen patients needed new surgery because of nonunion. The use of transpedicular fixation did not produce better results. The sense of coherence scale assessing the patient's successful coping capability had a very good predictive value in the whole series, and this predictive value was especially good in patients between 35 and 50 years of age. Also, the shorter duration of symptoms was an important predictor of a successful outcome, and the end results in patients who had a longer duration of preoperative low-back symptoms tended to be poor.

Adult↗
PubMed1985

Comparing physical and behavior therapy for chronic low back pain on physical abilities, psychological distress, and patients' perceptions.

A treatment-outcome study was conducted to study the impact of behavior and physical therapy on components of the chronic low back pain syndrome. Eighteen patients received behavior therapy and 15 patients received physical therapy. All patients had at least a 6-month history of seeking treatment for chronic low back pain. Prior to treatment patients were assessed in four principal areas of functioning: (1) physical abilities; (2) current physical functioning; (3) psychological and psychosocial functioning; and (4) pain intensity and pain perception. Treatments were conducted in a group (five to eight patients) outpatient setting. Both behavior therapy and physical therapy groups met for 10-weekly sessions, each lasting 2 hr. Behavior therapy was designed to address the environmental, social, and emotional components of the low back pain syndrome as well as the depression and decreased activity that result from chronic low back pain. Physical therapy was based upon traditional rehabilitation theory and was designed to improve low back function. Patients were reevaluated at posttreatment, 6 months, and 1 year. The results showed a general improvement for patients in both groups and a few treatment-specific differences in outcome measures.

Adaptation, Psychological↗