scholarly journals POS1289 CHRONIC LOW BACK PAIN: THERAPEUTIC STRATEGIES AND CLINICAL OUTCOMES IN A MILITARY POPULATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.2-926
Author(s):  
R. Dhahri ◽  
A. Dghaies ◽  
M. Slouma ◽  
L. Metoui ◽  
I. Gharsallah ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Physical Examination ◽  
Chronic Low Back Pain ◽  
Radicular Pain ◽  
Abdominal Muscles ◽  
Low Back ◽  
Number Of Patients ◽  
The Impact

Background:Low back pain is an extremely common patient complaint. Most cases resolve quickly after the acute episode. However, a significant number of patients develop chronic low back pain; a persistent disabling condition. Patients suffer from unremitting pain and often become functionally impaired.Objectives:The aim of this study is to describe the characteristics of chronic LBP, physical examination abnormalities, treatment strategies and the impact of LBP on the professional life of the patients.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology and orthopedics at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized investigation and clinical assessment.Results:The study included 80% of active military serving members and 20% of administrative officers. The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. Four patients were suffering from diabetes; two patients were suffering from high blood pressure. All the patients were suffering from chronic LBP lasting for an average of 66.4 months. LBP was associated with radicular pain in 78% of the cases. It was a unilateral radicular pain in 72% of the cases and bilateral in 28% of the cases. The main triggering factors were: carrying heavy loads in 98% of the cases, standing or sitting for long periods in 90% and 76% of the cases, tremors in 74% of the cases. Neuropathic pain was found in 26% of patients. Physical examination showed paravertebral muscle tenderness in 66% of the cases and slack abdominal muscles in 56% of the cases. Assessement of range of flexion of the lumbar spine showed: fingertip to floor test was 18 ±12.2 cm [054cm], schober test was +3.8±1.2cm [16cm]. The extension of lumbar spine was painful in 80% of the cases. A trigger point was found in 28% of the cases. Lasegue sign was positive in 18% of the cases. Leri’s test was positive in 8% of the cases. Required treatments during the last episode of LBP were: Paracetamol (62%), nonsteroidal antiinflammatory drugs (26%), tramadol (4%), myorelaxant (4%) and pregabalin (2%). Half of the patients needed functional rehabilitation. Forty percent of the patients reported improvement; 46% of them reported improvement then recurrence of the pain, 8% of them reported no improvement and 4% reported worsening of the symptoms. Thirty six percent of the patients needed an average of 21 days of leave and 35% of them needed exemption from work for LBP problems. One patient needed an outplacement from his original work and one patient needed an early retirement.Conclusion:Chronic low back pain can cause significant functional disability, and commonly becomes frustrating for both patients and physicians to cope with and treat. There is still no consensus on the best way to manage chronic low back pain, and clinical guidelines are scarce. A combination of pharmacological agents and non-pharmacological methods is the most appropriate therapeutic regimen.Disclosure of Interests:None declared

scholarly journals MECHANISM OF VERTICAL POSTURE FORMATION AND PARAMETERS OF SAGITTAL SPINOPELVIC BALANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN AND SCIATICA

2006 ◽  
pp. 061-069 ◽  
Author(s):  
Aleksandr Ivanovich Prodan ◽  
Vladimir Aleksandrovich Radchenko ◽  
Aleksey Nikolayevich Khvisyuk ◽  
Vladimir Aleksandrovich Kutsenko
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Chronic Low Back Pain ◽  
Sacral Slope ◽  
Vertical Posture ◽  
Protective Mechanism ◽  
Low Back ◽  
Number Of Patients ◽  
Spinopelvic Balance

Objective.To study parameters of sagittal spinopelvic balance in patients with chronic low back pain and sciatica, and mechanism of vertical posture formation in a sagittal plane.Material and Methods.Total of 100 patients (32 female and 68 male, mean age 38.7 years) with chronic low back pain and sciatica underwent clinical and radiological examinations. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and global lumbar lordosis (GLL) were measured on lateral standing radiograms. Statistical analysis of the obtained data was performed.Results.The mean value of PI (50.7°) in patients with back pain and sciatica and in healthy volunteers was almost equal, while SS and GLL were significantly lower in patients, and PT – higher, than those in volunteers. Number of patients with PI ≤ 35 was significantly higher than that of volunteers. Pearson’s correlation coefficient between GLL and PI was 0.916, between GLL and SS – 0.902, and between GLL and PT – 0.326. Vertical posture in patients with chronic low back pain and lumbar sciatica is characterised by backward pelvic rotation relative to hip and by hypolordotic shape of the lumbar spine.Conclusion.Vertical posture in patients with low back pain and sciatica is determined by a backward rotation of the pelvis, therefore SS and GLL decrease, and PT increases. A prevalence of extremely low values of PI (≤35°) may be considered as a risk factor for lumbar spine degenerative diease. Alteration of vertical posture is a kind of protective mechanism.

scholarly journals FRI0246 The impact social, labour and psychological of the chronic low back pain

2001 ◽  
Author(s):  
FP Torres ◽  
D Ybañez-García ◽  
P Pérez-Caballero ◽  
M Morales ◽  
A Llópis
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
The Impact

Associations between the severity of disability level and fear of movement and pain beliefs in patients with chronic low back pain

2020 ◽  
Vol 33 (5) ◽  
pp. 785-791 ◽  
Author(s):  
Nuray Alaca ◽  
Hande Kaba ◽  
Ayce Atalay
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Behavioral Therapy ◽  
Short Form ◽  
Low Back ◽  
Pain Beliefs ◽  
Fear Of Movement ◽  
Severity Of Disability ◽  
The Impact

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15. RESULTS: No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores. CONCLUSIONS: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.

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