scholarly journals P087: Overview of reviews: relevant treatment modalities for management of low back pain in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S107-S107
Author(s):  
B. Burgesson ◽  
J. Hayden ◽  
K. Magee
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Systematic Reviews ◽  
Functional Limitation ◽  
The United States ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Low Back ◽  
Nationally Representative

Introduction: Low Back Pain (LBP) remains a condition with relatively high incidence and prevalence. It affects 70-85% of people at some point in their lives and causes significant disability. LBP management may be best suited to a primary care setting, yet it is one of the most common reasons for presentation to Emergency Departments (ED). Nationally representative data from the United States found that LBP related disorders are a frequent cause of ED visits, accounting for 2.7 million visits to US EDs annually. There are numerous treatment modalities for LBP, however the task is identifying those that have relevance in an ED setting. Although there is extensive research available on management of LBP in primary care settings, treatment outcomes differ from that in the ED setting. This makes management of LBP a challenge for ED physicians. Few studies and no systematic reviews focus on treatment of LBP in the ED setting. Methods: The objective of our study is to compare effectiveness of treatment modalities relevant for management of LBP in the ED setting. We conducted an Overview of Systematic Reviews following robust methods advocated by Cochrane. We included systematic reviews of randomized controlled trials (RCTs). A medical librarian assisted in completing of an extensive search of the Cochrane Library, PubMed, and EMBASE. We used transparent criteria to select relevant reviews and assess interventions for ED relevance. We collected key data points from the included reviews including pain and functional limitation outcomes. Evidence will be synthesized for important outcome measures following the approach of Jones et al (2012). Results: We screened 4740 citations and identified 346 likely relevant systematic reviews. Comparative effectiveness review synthesis will be completed before the conference. We will report effectiveness of each of the included interventions and as well as make head to head comparisons of said relevant interventions. Conclusion: Currently most LBP patients presenting to the ED are inundated with a variety of potential treatment modalities, all alleging efficacy in LBP management. Physicians may use the evidence from this synthesis, and related knowledge translation tools, to guide decisions in effectively treating patients presenting to the ED with LBP.

scholarly journals The Prognosis of Acute Low Back Pain in Primary Care in the United States

Spine ◽  
2012 ◽  
Vol 37 (8) ◽  
pp. 678-684 ◽  
Author(s):  
Wolf E. Mehling ◽  
Viranjini Gopisetty ◽  
Elizabeth Bartmess ◽  
Mike Acree ◽  
Alice Pressman ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
The United States ◽  
Low Back ◽  
Acute Low Back Pain

Diagnostic Imaging Use for the Initial Evaluation of Low Back Pain by Primary Care Providers in the United States: 2011-2016

2019 ◽  
Vol 16 (11) ◽  
pp. 1522-1527 ◽  
Author(s):  
Jina Pakpoor ◽  
Micheal Raad ◽  
Andrew Harris ◽  
Varun Puvanesarajah ◽  
Joseph K. Canner ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Imaging ◽  
Primary Care Providers ◽  
The United States ◽  
Initial Evaluation ◽  
Low Back ◽  
Care Providers

Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review

Pain Medicine ◽  
2019 ◽  
Vol 21 (7) ◽  
pp. 1482-1493 ◽  
Author(s):  
Selaiman A Noori ◽  
Abdullah Rasheed ◽  
Rohit Aiyer ◽  
Boyoun Jung ◽  
Nitin Bansal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Neck Pain ◽  
Pain Intensity ◽  
Therapeutic Ultrasound ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Low Back

Background Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient’s desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBP and neck pain. Methods Using PRISMA guidelines, a search of the PubMed and CENTRAL (The Cochrane Library) databases was performed to retrieve randomized controlled trials (RCTs) that evaluated therapeutic ultrasound in patients with chronic LBP or neck pain. Results The search strategy identified 10 trials that met the criteria for inclusion. Three studies in LBP reported that both therapeutic and sham (placebo) ultrasound provided significant improvement in pain intensity. In each of these studies, ultrasound was found to be more effective than placebo when using only one of several validated instruments to measure pain. Three of the four studies on neck pain demonstrated significant pain relief with ultrasound in combination with other treatment modalities. However, only one of these studies demonstrated that the use of ultrasound was the cause of the statistically significant improvement in pain intensity. Conclusions Therapeutic ultrasound is frequently used in the treatment of LBP and neck pain and is often combined with other physiotherapeutic modalities. However, given the paucity of trials and conflicting results, we cannot recommend the use of monotherapeutic ultrasound for chronic LBP or neck pain. It does seem that ultrasound may be considered as part of a physical modality treatment plan that may be potentially helpful for short-term pain relief; however, it is undetermined which modality may be superior. In both pain syndromes, further trials are needed to define the true effect of low-intensity ultrasound therapy for axial back pain. No conclusive recommendations may be made for optimal settings or session duration.

PC0007 Inflammatory low back pain features at primary care

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 724.4-725
Author(s):  
L. Myasoutova ◽  
S. Lapshina ◽  
M. Protopopov ◽  
S. Erdes
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back

scholarly journals Estimating the population health burden of musculoskeletal conditions using primary care electronic health records

Rheumatology ◽  
2021 ◽  
Author(s):  
Dahai Yu ◽  
George Peat ◽  
Kelvin P Jordan ◽  
James Bailey ◽  
Daniel Prieto-Alhambra ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Electronic Health Records ◽  
High Impact ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Health Records ◽  
Electronic Health

Abstract Objectives Better indicators from affordable, sustainable data sources are needed to monitor population burden of musculoskeletal conditions. We propose five indicators of musculoskeletal health and assessed if routinely available primary care electronic health records (EHR) can estimate population levels in musculoskeletal consulters. Methods We collected validated patient-reported measures of pain experience, function and health status through a local survey of adults (≥35 years) presenting to English general practices over 12 months for low back pain, shoulder pain, osteoarthritis and other regional musculoskeletal disorders. Using EHR data we derived and validated models for estimating population levels of five self-reported indicators: prevalence of high impact chronic pain, overall musculoskeletal health (based on Musculoskeletal Health Questionnaire), quality of life (based on EuroQoL health utility measure), and prevalence of moderate-to-severe low back pain and moderate-to-severe shoulder pain. We applied models to a national EHR database (Clinical Practice Research Datalink) to obtain national estimates of each indicator for three successive years. Results The optimal models included recorded demographics, deprivation, consultation frequency, analgesic and antidepressant prescriptions, and multimorbidity. Applying models to national EHR, we estimated that 31.9% of adults (≥35 years) presenting with non-inflammatory musculoskeletal disorders in England in 2016/17 experienced high impact chronic pain. Estimated population health levels were worse in women, older aged and those in the most deprived neighbourhoods, and changed little over 3 years. Conclusion National and subnational estimates for a range of subjective indicators of non-inflammatory musculoskeletal health conditions can be obtained using information from routine electronic health records.

scholarly journals Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Le Ge ◽  
Chuhuai Wang ◽  
Haohan Zhou ◽  
Qiuhua Yu ◽  
Xin Li
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Elderly People ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Original Research ◽  
Low Back ◽  
Centre Of Pressure ◽  
Balance Performance

Abstract Background Research suggests that individuals with low back pain (LBP) may have poorer motor control compared to their healthy counterparts. However, the sample population of almost 90% of related articles are young and middle-aged people. There is still a lack of a systematic review about the balance performance of elderly people with low back pain. This study aimed to conduct a systematic review and meta-analysis to understand the effects of LBP on balance performance in elderly people. Methods This systematic review and meta-analysis included a comprehensive search of PubMed, Embase, and Cochrane Library databases for full-text articles published before January 2020. We included the articles that 1) investigated the elderly people with LBP; 2) assessed balance performance with any quantifiable clinical assessment or measurement tool and during static or dynamic activity; 3) were original research. Two independent reviewers screened the relevant articles, and disagreements were resolved by a third reviewer. Results Thirteen case-control studies comparing balance performance parameters between LBP and healthy subjects were included. The experimental group (LBP group) was associated with significantly larger area of centre of pressure movement (P < 0.001), higher velocity of centre of pressure sway in the anteroposterior and mediolateral directions (P = 0.01 and P = 0.02, respectively), longer path length in the anteroposterior direction (P < 0.001), slower walking speed (P = 0.05), and longer timed up and go test time (P = 0.004) than the control group. Conclusion The results showed that balance performance was impaired in elderly people with LBP. We should pay more attention to the balance control of elderly people with LBP.

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