Industrial Low-Back Pain A Prospective Evaluation of a Standardized Diagnostic and Treatment Protocol

Spine ◽  
1984 ◽  
Vol 9 (2) ◽  
pp. 199-203 ◽  
Author(s):  
SAM W. WIESEL ◽  
HENRY L. FEFFER ◽  
RICHARD H. ROTHMAN
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Treatment Protocol ◽  
Low Back ◽  
Prospective Evaluation ◽  
Standardized Diagnostic

scholarly journals Effect of Medicinal Cannabis Therapy (Mct) On Severity of Chronic Low Back Pain, Sciatica and Lumbar Range of Motion

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Chronic Low Back Pain ◽  
Sagittal Plane ◽  
Treatment Protocol ◽  
Adjunctive Treatment ◽  
Low Back ◽  
Patient Reported ◽  
Medicinal Cannabis

Background: Anecdotal evidence indicates the possible efficacy of cannabis use as an adjunctive treatment in chronic low back pain. The purpose of the current study was to assess the results of treatment of patients suffering from chronic low back pain by medicinal cannabis (MCT). Methods: A cohort of 46 patients was followed for a minimum of twelve months. They were evaluated at baseline prior to MCT, 3 months later when MCT was begun and up to 12 months of MCT by patient reported outcome questionnaire (SF-12), visual analogue scale (VAS) and the Brief Pain Inventory (BPI), back specific function was assessed using the Oswestry score, range of motion was measured using the Saunders digital inclinometer. Opiate use was assessed using pharmacy dispensation records at baseline and after 12 months of MCT. Inclusion criteria included: age over 25 years, sciatica with documented treatment for at least 12 months, evidence on CT or MRI scan of disc herniation or spinal stenosis, failure of at least two narcotic drugs, and consent to use medicinal cannabis. Exclusion criteria included evidence of bone cancer, evidence of diabetic neuropathy, and evidence of prior psychotic reactions. Treatment protocol: Cannabis usage was at a fixed dosage of 20 grams per month, dose increase was considered at least after 6 months of treatment. The cannabis was smoked at a recommended rate of 4 dosages per day. Results: After 12 months of MCT BPI VAS decreased from 8.4 ± 1.4 to 2.0 ± 2.0; SF12-PCS improved from 47 ± 14 to 55 ± 12; SF12-MCS improved from 44 ± 6 to 50 ± 10; and sagittal plane active range of motion improved from 34º ± 8º degrees to 48º ± 8º, In conclusion, short term usage of smoked medicinal cannabis appear to improve both physical and mental function while decreasing pain levels of chronic low back pain sufferers.

scholarly journals Ultrasound-Guided percutaneous neuromodulation in non-radiating low back pain

2019 ◽  
Vol 02 (02) ◽  
pp. 124-124
Author(s):  
Sanmartin Enriquez F. ◽  
Valera Garrido F. ◽  
Álvarez Prats D. ◽  
Carvajal Fernández O.
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Protocol ◽  
Wilcoxon Test ◽  
Medial Branch ◽  
Low Back ◽  
Ultrasound Guided ◽  
Final Sample ◽  
Multiple Treatments

Abstract Background Low back pain is very common, affecting 15–20% of the population each year, and representing of the main causes of physical therapy consultations. Multiple treatments have been defined for chronic low back pain, however, the findings are still controversial, and therefore new and improved solutions are necessary for the population who suffers from low back pain. Aims To evaluate the effectiveness of ultrasound-guided percutaneous neuromodulation (US-guided PNM) in patients with non-radiating low back pain. Material and Methods An experimental study was performed in patients with non-radiating low back pain, between the months of march and may of 2018 at the F&S-Narón Physical Therapy clinic, in A Coruña. Functionality was evaluated via the Oswestry questionnaire and pain was evaluated using the visual analog scale (VAS). US-guided NMP was applied to stimulate the medial branch of a L2 posterior ramus and the iliohypogastric and ilioinguinal nerves, following the protocol described by Valera & Minaya, which consists of the application of a PES type current at 10Hz and 240 microseconds, during 15 seconds and for 6 applications. In total, 3 sessions were applied (sequence 1:7:7), once a week after the first week of initiating treatment. Results Initially, 12 patients participated in the study, aged between 32 and 59 years. The mean age was 41.4 years. Two of the patients abandoned the study due to personal reasons, unrelated to the research. The final sample consisted of 10 subjects, 50% of each sex. 80% of patients improved after the application of the treatment protocol. An important decrease in activity limitations was observed, from 14 to 4.35 points out of 100 according to the Oswestry questionnaire, and a decrease of 6.8 to 2.15 points out of 10 was observed on the VAS scale, which was statistically significant according to the Wilcoxon test (p < 0,05). Conclusions The ultrasound-guided percutaneous neuromodulation technique used was effective, obtaining positive results in relation to pain and functionality. Clinical studies are necessary with a greater sample size to confirm these findings.

scholarly journals Methodology and demographics of a single blinded, randomized controlled trial of chiropractic compared to physical therapy for balance impairments in community dwelling geriatric patients with or without low back pain

2014 ◽  
Vol 22 (1) ◽  
Author(s):  
Dennis E Enix ◽  
Kasey L Sudkamp ◽  
Theodore K Malmstrom ◽  
Joseph H Flaherty
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Treatment Protocol ◽  
Chiropractic Care ◽  
Community Dwelling ◽  
Self Report ◽  
Low Back ◽  
Geriatric Population ◽  
Randomized Controlled

Abstract Background Postural control problems effect between 28% and 35% of individuals over the age 65 and increases with age. Musculoskeletal pain in the elderly impacts 20% to 49% of people between the ages of 65 and 75, is a leading falls risk factor, and a robust predictor of morbidity. Polypharmacy in the management of chronic pain is common in the geriatric population. Conservative treatment options for balance and back pain are underrepresented in scientific literature. Methods The methods and demographics for a prospective, randomized controlled single blinded clinical trial are described. This study evaluated the use of either chiropractic care or physical therapy as a treatment for patients with balance problems and with low back pain (68.5%) or without low back pain (31.5%) in the geriatric population. One hundred and sixty eight consecutively enrolled community dwelling adults between 60 and 85 years old (72.8 +/- 6.8) were randomly assigned to 6 weeks of either chiropractic care or physical therapy (12 - 18 visits). Testing occurred prior to randomization, after 6 weeks of treatment, and again 6 weeks later. Functional and self-report outcome measures for balance included the Berg Balance Scale, Performance Oriented Mobility Assessment, Timed Up and Go Test, and NeuroCom balance tests. Pain was assessed with the Visual Analog Scale, 21-Point Box Scale, and pressure algometry. Quality of life healthcare questionnaires included the Oswestry, the SF-36, and the Falls Efficacy Scale for confidence in performing everyday activities. Data analysis for this intent-to-treat design was a mixed-model analysis of variance (ANOVA) (p < 0.05) and Bonferroni correction (p < 0.017 and p < 0.025). This study was set in a university biomedical and healthcare research facility and university ethics committee approval was obtained and written informed consent was given by all study participants. Conclusion The methodology of this multimodal treatment protocol for balance disorders and low back pain in the geriatric population and patient demographics are described in this paper. Additional research in this area is needed for this growing at risk population. Trial registration NCT02031562.

scholarly journals Effects of myofascial techniques on pain, mobility and function in patients with low back pain: a double-blind, controlled and randomized trial

2020 ◽  
Vol 18 ◽  
pp. 1-6
Author(s):  
Fabiana Forti Sakabe ◽  
Danielle Audickas Mazer ◽  
Julia Alves Cia ◽  
Daniel Iwai Sakabe ◽  
Gustavo Luiz Bortolazzo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Treatment Protocol ◽  
Spinal Mobility ◽  
Iliopsoas Muscle ◽  
Control Group ◽  
Low Back ◽  
Chain Flexibility ◽  
Quadratus Lumborum

Introduction: Low back pain is one of the most frequent causes of disability, with several associated etiologies. Osteopathic manipulative treatment is widely used to evaluate and manage musculoskeletal disorders. The aim of the study was to evaluate the immediate and late effects of 3 sessions of myofascial osteopathic techniques on pain intensity, posterior chain flexibility, lumbar mobility and level of disability in patients with chronic low back pain. Methods: 60 subjects of both genders, randomly divided into 3 experimental groups: healthy control (HC n = 20), low back pain control group (CG, n = 20) and treated low back pain group (TG, n = 20). Initially, the 3 groups were evaluated using the Visual Analogue Scale (VAS), Oswestry questionnaire, Wells bench and measurement of lateral spine tilt and fingertip-to-floor test. The TG was submitted to 3 sessions of myofascial techniques (lasting 40 minutes), 1x / week. The session consisted of the application of 6 myofascial techniques (thoracolumbar fascia, quadratus lumborum fascia, iliopsoas muscle stretching, quadratus lumborum stretching and iliolumbar ligaments). Subjects were reevaluated immediately after the first session, 7 days after the last session and one month after treatment completion (follow up). Results: There was an improvement in posterior chain flexibility (20.3 ± 7.4 cm pre to 26.3 ± 8 cm after 3 sessions), spinal mobility (fingertip-to-floor: 13.3 ± 11.33 cm pre to 4.8 ± 10.5 cm after 3 sessions), as well as pain intensity reduction (3.3 ± 1.9 cm pre to 1 ± 1.7 after 3 sessions) and reduction in the level of lumbar disability (15.8 ± 7.3 in the pre to 9.2 ± 8.6 after 3 sessions) for TG. In HC and CG there was no change in any of the variables. The results shown for TG remained even one month after the intervention. Conclusion: The osteopathic treatment protocol with myofascial techniques was effective for the treatment of low back pain.

scholarly journals Benefits of Back School in functional capacity and pain intensity of patients with chronic low back pain.

2014 ◽  
Vol 12 ◽  
pp. 161
Author(s):  
Adriane Behring Bianchi ◽  
Livia Nóbrega Meneguetti ◽  
Salmia Mendes Baladeli ◽  
Ligia Maria Facci
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Functional Capacity ◽  
Chronic Low Back Pain ◽  
Treatment Protocol ◽  
Low Back ◽  
School Program ◽  
Back School ◽  
Phone Calls

Introduction: Due to the high incidence of low back pain in the population, is very important to study methods of prevention and treatment for this disease. The Back School, an approach that aims to provide to participants the increase of self-care, associating primary prevention to health education, has been suggested for the treatment of patients with chronic low back pain. Objective: The aim of this study was to evaluate the benefits of Back School on functional capacity and pain intensity, in short and medium term, at patients with chronic low back pain. Methods: Fifty eight patients with chronic low back pain, selected at UniCesumar physical therapy's clinic, were evaluated, by an independent examiner, using Roland-Morris Questionnaire, Pain Visual Analogue Scale and asked about consumption of medications. In sequence, all the pacients were randomized into two groups: 1) School Program and 2) Control. The group 1 patients participated of Back School program, composed of theoretical-practical classes, twice per week, totaling ten classes of 60 minutes; and group 2 were followed only by phone calls. The data were statistically analyzed by Mann-Whitney U test, Friedman and Wilcoxon, using the significant values of p < 0,05. Results: Fifty three patients finished the study and were analyzed after the treatment protocol, as well as three and six months sequent. The improvement in pain intensity and functional capacity was statistically significant only in the Back School group. Conclusion: In this study, it was found effectiveness of Back School program in the improve of functional capacity and pain intensity of patients with chronic low back pain.

scholarly journals Spondylodiscitis due to Cutibacterium acnes following lumbosacral intradiscal biologic therapy: a case report

2019 ◽  
Vol 14 (9) ◽  
pp. 823-829
Author(s):  
Nicholas R Beatty ◽  
Cole Lutz ◽  
Kwadwo Boachie-Adjei ◽  
Teresita A Leynes ◽  
Christopher Lutz ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Treatment Protocol ◽  
Low Back ◽  
Acute Phase Reactants ◽  
Plasma Injection ◽  
Cutibacterium Acnes ◽  
Night Sweats ◽  
History Of

A 40-year-old woman with a history of chronic low back pain underwent a fluoroscopically guided intradiscal platelet-rich plasma injection (PRP) at the L5–S1 level. She subsequently developed progressive low back pain, night sweats and decreased ability to ambulate. Laboratory work-up revealed elevated acute phase reactants and imaging revealed L5–S1 intervertebral disc and vertebral end-plate abnormalities highly suggestive of spondylodiscitis. Computed tomography-guided aspiration and biopsy cultures grew Cutibacterium acnes and the patient was subsequently treated with intravenous antibiotics without surgical management. To the best of our knowledge, this is the first published case of lumbar spondylodiscitis following an intradiscal PRP injection, and brings to the forefront several clinically relevant issues including the antimicrobial effects of PRP, the role of C. acnes in spine infections and the ideal treatment protocol for intradiscal biologics in order to minimize morbidity and optimize functional outcomes.

scholarly journals The effectiveness of Spinal Manipulative Therapy (SMT) In the management of nonspecific Low Back Pain (LBP)

2020 ◽  
Author(s):  
Scalella Roberto
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Clinical Trials ◽  
Treatment Protocol ◽  
Spinal Manipulative Therapy ◽  
Standard Of Care ◽  
Evidence Based ◽  
Low Back ◽  
The Real ◽  
Manipulative Therapy

A systematic review of a number of studies in order to verify the real effectiveness of Spinal Manipulative Therapy (SMT) for management of nonspecific Low Back pain in order to relieve pain, improve function and diminish disability. It is known that the diagnosis of low back pain is a difficult matter, due to different causes related to it, not always readily apparent, considering the main distinction between specific and non-specific low back pain, in this review, a special attention has been dedicated on the second one. Despite many published randomized clinical trials, a substantial number of reviews and several clinical guidelines, the real effectiveness of this therapy to manage nonspecific low back pain is still minimal. Following the most recent North American Spine Society (NASS) guidelines, this review considers selected and high quality studies with more stringent criteria of evidence-based admissibility, and by the way, a special attention has been paid on the studies that, more than other, tried to assess the effect of spinal manipulation SMT compared to other kind of therapies in patients with nonspecific LBP. It should be noted that this study is designed to be a simple review of the best evidence based recommendations so it should not be seen as a standard of care, or a treatment protocol with type, frequency and duration of intervention available for everyone.

scholarly journals Systematic review on the incidence of low back pain as well as on the rehabilitation treatment methods used

2020 ◽  
pp. 417-420
Author(s):  
Catalin IONITE ◽  
Mariana ROTARIU ◽  
Iustina CONDURACHE
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Lower Cost ◽  
Pain Treatment ◽  
Treatment Protocol ◽  
Alternative Therapies ◽  
Low Back ◽  
Beneficial Effects ◽  
Optimal Protocol

Introduction. Low back pain is a growing condition both in terms of sampling and incidence, reaching to affect any of us at some point. Material and method. In order to write the article, four international libraries were used, where search criteria were used such as: "low back pain", "low back pain incidence" and "low back pain treatment". The articles used in this paper were carefully selected according to their relevance for this study, but only considered articles published in 2020. Results and discussions. The obtained results indicated that both physical therapy and physiotherapy have beneficial effects in ameliorating the symptoms generated by low back pain, but due to the lack of an optimal protocol patients turn to alternative therapies that have shown greater efficacy than physical therapy in amelioration. symptoms generated by low back pain. Conclusions. The lack of an optimal physiotherapeutic treatment protocol causes patients to turn to alternative therapies that are more effective, as well as a lower cost per treatment.

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