scholarly journals Efficacy of metamizole versus ibuprofen and a short educational intervention versus standard care in acute and subacute low back pain: a study protocol of a randomised, multicentre, factorial trial (EMISI trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048531
Author(s):  
Maria M Wertli ◽  
Julian S Flury ◽  
Sven Streit ◽  
Andreas Limacher ◽  
Vanessa Schuler ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Educational Intervention ◽  
Rating Scale ◽  
Opioid Analgesic ◽  
National Science Foundation Grant ◽  
Low Back ◽  
Subacute Low Back Pain ◽  
Short Intervention

IntroductionLow back pain (LBP) is among the top three most common diseases worldwide, resulting in a life with pain-related disability. To date, no study has assessed the efficacy of metamizole (dipyrone), a non-opioid analgesic and antipyretic prodrug compared with the conventional non-steroidal anti-inflammatory drug ibuprofen, in patients with an acute LBP episode. Further, it is unclear, whether a short educational intervention is superior to usual care alone.ObjectivesThe objective of this study is to assess first, whether metamizole is non-inferior to ibuprofen in a new episode of acute or subacute LBP. Second, we aim to assess whether a short educational intervention including evidence-based patient information on the nature of LBP is superior to usual care alone.Methods and analysisAn investigator-initiated multicentre, randomised, double blind trial using a factorial design will be performed. A total of 120 participants with a new episode of LBP will be recruited from GP practices, outpatient clinics and from emergency departments, and randomised into four different treatment groups: ibuprofen alone, ibuprofen and short intervention, metamizole alone, metamizole and short intervention. The primary endpoint for the medical treatment will be change in pain assessed on an 11-point Numeric Rating Scale after 14 days. The primary outcome for the short intervention will be change in the Core Outcome Measures Index assessed after 42 days.Ethics, dissemination and fundingThis study has been approved by the responsible Ethics Board (Ethikkommission Bern/2018-01986) and the Swiss Agency for Therapeutic Products (Swissmedic/2019DR4002). Results will be published in open access policy peer-reviewed journals. The study is funded by the Swiss National Science Foundation (grant number 32 003B-179346).Trial registration numberNCT04111315

scholarly journals Efficacy of Mobile Health in Patients with Low Back Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Mingrong Chen ◽  
Tingting Wu ◽  
Meina Lv ◽  
Zongwei Fang ◽  
Zhiwei Zeng ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Pain Intensity ◽  
Mobile Health ◽  
Rating Scale ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Cochrane Library ◽  
Low Back

BACKGROUND Low back pain is one of the most common health problems and a main cause of disability, which imposes a great burden on patients. Mobile health (mHealth) affects many aspects of people's lives, and it has progressed rapidly, showing promise as an effective intervention for patients with low back pain. However, the efficacy of mHealth interventions for patients with low back pain remains unclear; thus, further exploration is necessary. OBJECTIVE The purpose of this study was to evaluate the efficacy of mHealth interventions in patients with low back pain, compared to usual care. METHODS We searched for studies published in English before October 2020 in PubMed, EMBASE, Web of Science, and the Cochrane Library. Two researchers independently scanned the literature, extracted data, and assessed the methodological quality of the included studies. We used RevMan 5.4 software to perform the meta-analysis. RESULTS A total of 10 studies with 1003 participant, met the inclusion criteria. The simultaneous use of mHealth and usual care showed a greater reduction in pain intensity than usual care alone, as measured by the Numeric Rating Scale (mean difference [MD] -0.85, 95% CI -1.29 to -0.40; P<.001), and greater efficacy in reducing disability, as measured by the Rolland-Morris Disability Questionnaire (MD -1.58, 95% CI -2.33 to -0.83; P<.001). CONCLUSIONS The simultaneous interventions of mHealth and usual care has greater efficacy than usual care alone in reducing pain intensity and disability in patients with low back pain.

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

2012 ◽  
Author(s):  
Daniel Rhon ◽  
Julie Fritz ◽  
Joshua Cleland ◽  
Deydre Teyhen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Low Back

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

2014 ◽  
Author(s):  
Daniel Rhon ◽  
Julie Fritz ◽  
Joshua Cleland ◽  
Deydre Teyhen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Low Back

scholarly journals Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Low Back ◽  
Residential Setting ◽  
Wide Range

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

Shared and Independent Associations of Psychosocial Factors on Work Status Among Men With Subacute Low Back Pain

2007 ◽  
Vol 23 (5) ◽  
pp. 409-416 ◽  
Author(s):  
William S. Shaw ◽  
Adrienne Means-Christensen ◽  
Mark A. Slater ◽  
Thomas L. Patterson ◽  
John S. Webster ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Psychosocial Factors ◽  
Work Status ◽  
Low Back ◽  
Subacute Low Back Pain

scholarly journals Effect of Physiotherapy Treatment in the Autonomic Activation and Pain Perception in Male Patients with Non-Specific Subacute Low Back Pain

2021 ◽  
Vol 10 (8) ◽  
pp. 1793
Author(s):  
Vanesa Abuín-Porras ◽  
Vicente Javier Clemente-Suárez ◽  
Gonzalo Jaén-Crespo ◽  
Emmanuel Navarro-Flores ◽  
Helios Pareja-Galeano ◽  
...  
Keyword(s):  
Nervous System ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Perception ◽  
Soft Tissues ◽  
Low Back ◽  
Physiotherapy Treatment ◽  
Subacute Low Back Pain ◽  
Subjective Pain ◽  
System Activation

Introduction: Physiotherapy treatment is a common intervention for low back pain (LBP) patients. These interventions have been related to physiological effects in the central nervous system. Thus, the aim of this study was to analyze the effect of physiotherapy treatment in patients with LBP in the autonomic nervous system activation and subjective pain perception of patients. Methods: A total of 30 male subjects diagnosed with non-specific subacute LBP received a 50 min session consisting of (a) a manual therapy based on joint mobilization and soft tissues techniques in the lumbo-pelvic area, (b) a stretching program, and (c) motor control exercises of the core muscles. The autonomic modification of participants was assessed prior to and after the physiotherapy treatment. Results: Heart rate variability (HRV) analysis reported a significant increase in average RR (p = 0.001), RMSSD (p = 0.008), LRMSSD (p = 0.001), SDNN (p = 0.005), and PNN50 (p = 0.024) after the session. Frequency-domain measures showed a significant increase in LF (p = 0.030) and HF (p = 0.014), and a decrease in LF/HF ratio (p = 0.046). A significant decrease was found in minimum HR values (p = 0.001) and average HR (p = 0.001). Moreover, maximal HR decreased its value from 116.7 ± 26.1 to 113.7 ± 40.8 after intervention. In addition, subjective pain perception (VAS scores) was significantly lower (p = 0.001) in the post-session assessment. Conclusions: Physiotherapy treatment produced an increase in parasympathetic nervous system activation and a decrease in subjective pain perception in non-specific subacute LBP patients.

Management Approach Combining Prognostic Screening and Targeted Treatment for Patients with Low Back Pain Compared with Standard Physiotherapy: A Systematic Review & Meta-analysis

2021 ◽  
pp. 7
Author(s):  
Collins Ogbeivor
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
English Language ◽  
Weighted Mean Difference ◽  
Economic Benefits ◽  
Management Approach ◽  
Controlled Trials ◽  
Low Back ◽  
Stratified Care

Introduction: Research evidence suggests that a stratified care management approach is better at improving clinical and economic outcomes for low back pain (LBP) patients compared with usual care in the short term. However, it is unclear if these health and economic benefits are sustainable in the longer term. The aim of this study was, therefore, to determine the effectiveness of stratified care compared with standard physiotherapy for LBP treatment. Methodology: A comprehensive search was undertaken of seven electronic databases (CINAHL, MEDLINE, Pedro, EMBASE, PsycINFO, Cochrane Register for Controlled Trials, and Web of Science with full text). Although no time limits were applied, studies were limited to English language publications and those involving human participants only. Study selection, data extraction, and appraisal of study were independently undertaken by both reviewers (CO and LE). Result: In total, 6842 patients (aged 18 years and above) were included in the eight trials reviewed;  four were randomized controlled trials (RCTs) and four were non-RCTs. The pooled analysis of three studies (n = 2460) demonstrated a strong evidence in favor of stratified care over standard care at improving overall pain (Weighted Mean Difference (WMD) [random] 0.46 [95% CI 0.21, 0.71]; P < 0.0003), with overall effect (Z = 3.6) and (Roland-Morris disability questionnaire (RMDQ) scores (WMD [random] 0.71 [95% CI 0.05, 1.37]; P < 0.03), with overall effect (Z = 2.11) at three-, four-, and six-months’ follow-up periods. Conclusion: This current review demonstrated that a stratified care approach provides substantial clinical, economic, and health-related cost benefits in the medium- and high-risk subgroups compared with usual care. Further research is needed for longer-term benefits.

scholarly journals Association of Serum Serotonin and Pain in Patients with Chronic Low Back Pain before and after Spinal Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Afshin Farhanchi ◽  
Behrouz Karkhanei ◽  
Negar Amani ◽  
Mashhood Aghajanloo ◽  
Elham Khanlarzadeh ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Back ◽  
Significant Difference ◽  
Before And After ◽  
Postoperative Serum ◽  
Serum Serotonin

Introduction. In this study we are aiming to evaluate the changes of serum serotonin and its association with pain in patients suffering from chronic low back pain before and after lumbar discectomy surgery. Patients and Methods. A prospective study was performed on the patients referring to the outpatient clinic in Besat hospital, Hamadan University of Medical Sciences, Hamadan, Iran, during 2016. A 2 mL fasting blood sample was collected from each patient at preoperative day 1 and postoperative day 14 and they were measured for level of serum serotonin. Besides, all patients were asked for severity of their low back pain in preoperative day 1 and postoperative day 14 and scored their pain from zero to ten using a Numerical Rating Scale. Results. Forty patients with the mean age of 47 ± 13 yrs/old (range 25–77) including 15 (37.5%) males were enrolled into the study. The overall mean score of preoperative pain was significantly decreased from 7.4 ± 2.18 (range 4–10) to the postoperative pain score 3.87 ± 2.92 (range 0–10) (P < .001). The overall levels of pre- and postoperative serum serotonin were 3.37 ± 1.27 (range 1.1–6.4) and 3.58 ± 1.32 (range .94–7.1) ng/mL, respectively, with no significant difference (P = .09). The levels of pre- and postoperative serum serotonin were significantly higher in males and patients older than 50 yrs/old compared to the females and patients younger than 50 yrs/old, respectively (P = .03 and .005, respectively). A significant inverse correlation between the postoperative levels of pain and serum serotonin was observed (r = -.36 and P = .02). Conclusion. A negative medium strength linear relationship may exist between the postoperative serum serotonin and low back pain.

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