scholarly journals Differences in Nonspecific Low Back Pain between Young Adult Females with and without Lumbar Scoliosis

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Wangshu Yuan ◽  
Jianxiong Shen ◽  
Lixia Chen ◽  
Hai Wang ◽  
Keyi Yu ◽  
...  

Study design. Retrospective characterization of nonspecific low back pain (NSLBP) in young adult female patients with and without lumbar scoliosis. Background. There is no consensus as to whether NSLBP in scoliosis patients is related to scoliosis per se or is just a normal symptom that could happen in anyone. Objectives. The aim of this study was to compare the differences in NSLBP between young adult female patients with and without lumbar scoliosis and to provide a theoretical basis for differential treatment of NSLBP in patients with and without lumbar scoliosis. Methods. Ninety female young adults with NSLBP were divided into scoliosis and nonscoliosis groups. Characteristics of pain, lumbar mobility, muscle strength, Cobb angle, axial trunk rotation (ATR) angle, and surface electromyography (SEMG) signal were compared between the two groups. Results. The pain location in scoliotic patients was more concentrated on the left side of the lumbar spine (P≤0.001). The area affected by pain (P=0.028) and the numerical pain rating scale (NPRS) scores (P=0.014) of scoliotic patients were less than those of nonscoliotic patients. The difference between side-bending in scoliotic patients was greater than that in nonscoliotic patients (P=0.001). Scoliotic patients exhibited a significantly better ability for flexion (P=0.001) and extension (P=0.017) than nonscoliotic patients. The posterior muscles in scoliotic patients were stronger than those in nonscoliotic patients (P=0.014). The ratio of root-mean-square (RMS) on paraspinal muscles in scoliotic patients was greater than that in nonscoliotic patients (P≤0.001). Scoliotic patients exhibited greater relaxation time during the flexion-relaxation phenomenon (FRP) than nonscoliotic patients (P=0.024). Conclusions. The characteristics of NSLBP experienced by patients with lumbar scoliosis were distinct from those of NSLBP experienced by nonscoliotic patients. The treatment of NSLBP in scoliotic patients should be different from that in nonscoliotic patients.

2014 ◽  
Vol 22 (1) ◽  
Author(s):  
Cynthia K Peterson ◽  
Daniel Mühlemann ◽  
Barry Kim Humphreys

Abstract Background Low back pain in pregnancy is common and research evidence on the response to chiropractic treatment is limited. The purposes of this study are 1) to report outcomes in pregnant patients receiving chiropractic treatment; 2) to compare outcomes from subgroups; 3) to assess predictors of outcome. Methods Pregnant patients with low back or pelvic pain, no contraindications to manipulative therapy and no manual therapy in the prior 3 months were recruited. Baseline numerical rating scale (NRS) and Oswestry questionnaire data were collected. Duration of complaint, number of previous LBP episodes, LBP during a previous pregnancy, and category of pain location were recorded. The patient’s global impression of change (PGIC) (primary outcome), NRS, and Oswestry data (secondary outcomes) were collected at 1 week, 1 and 3 months after the first treatment. At 6 months and 1 year the PGIC and NRS scores were collected. PGIC responses of ‘better’ or ‘much better’ were categorized as ‘improved’. The proportion of patients ‘improved’ at each time point was calculated. Chi-squared test compared subgroups with ‘improvement’. Baseline and follow-up NRS and Oswestry scores were compared using the paired t-test. The unpaired t-test compared NRS and Oswestry scores in patients with and without a history of LBP and with and without LBP during a previous pregnancy. Anova compared baseline and follow-up NRS and Oswestry scores by pain location category and category of number of previous LBP episodes. Logistic regression analysis also was also performed. Results 52% of 115 recruited patients ‘improved’ at 1 week, 70% at 1 month, 85% at 3 months, 90% at 6 months and 88% at 1 year. There were significant reductions in NRS and Oswestry scores (p < 0.0005). Category of previous LBP episodes number at one year (p = 0.02) was related to ,improvement’ when analyzed alone, but was not strongly predictive in logistic regression. Patients with more prior LBP episodes had higher 1 year NRS scores (p = 0.013). Conclusions Most pregnant patients undergoing chiropractic treatment reported clinically relevant improvement at all time points. No single variable was strongly predictive of, improvement’ in the logistic regression model.


2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  

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.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Afshin Farhanchi ◽  
Behrouz Karkhanei ◽  
Negar Amani ◽  
Mashhood Aghajanloo ◽  
Elham Khanlarzadeh ◽  
...  

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.


Author(s):  
Julieta Seixas-Moizes ◽  
Anneke Boerlage ◽  
Érica Negrini Lia ◽  
Lucas Emmanuel Lopes e Santos ◽  
Miriane Lucindo Zucoloto ◽  
...  

<b><i>Introduction:</i></b> This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia. <b><i>Methods:</i></b> This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity. <b><i>Results:</i></b> The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach’s alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen’s kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94–0.97), showing a significant correlation between the total scores of REPOS-P and NRS. <b><i>Conclusion:</i></b> The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P.


2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Adesola Ojo Ojoawo ◽  
Taiwo Oluwaseun Arasanmi ◽  
Chidozie Emmanuel Mbada

Background: Non-specific low-back pain (NSLBP) is a common health problem worldwide, but the perception and coping strategies used by patients are underreported. Objectives: The objectives of the study were to evaluate the perception of patients with NSLBP, the ways the pain interrfered with their basic life, and coping strategies employed by them. Methods: Twenty patients consisting of 10 males (50%) and 10 females (50%) participated in this study. A qualitative interview was conducted using a three-section modified structured interview guide by Gwenda. Section A contained sociodemographic information, section B was the numerical pain rating scale, and section C asked questions about the pain duration, the ways of pain interference with the patient’s life, and strategies used to cope with pain. The data were analyzed using thematic content analysis. Results: The results showed that 50% of the patients were within the age range of 58 years or above. Ten (50%) patients perceived that NSLBP was caused by work-related activities and 10% perceived that NSLBP was a spiritual problem. Fifty percent reported that the pain interfered with their activities of daily living, and four (20%) mentioned that NSLBP interfered with their sexual function and religious activities. Concerning the coping strategy, 40% used prayer, 15% usually ignored the pain, and 35% used the conventional approach. Conclusions: It can be concluded that half of the patients with NSLBP perceived NSLBP to be caused by work-related activities. Besides, NSLBP interfered with basic activities of daily living, and about 40% were coping with NSLBP with prayer and spiritual means.


2014 ◽  
Vol 10 (5) ◽  
pp. 323 ◽  
Author(s):  
Aleksandra Zgierska, MD, PhD ◽  
Margaret L. Wallace, PharmD, BCACP ◽  
Cindy A. Burzinski, MS ◽  
Jennifer Cox, BS ◽  
Miroslav Backonja, MD

Objective: Refractory chronic low back pain (CLBP) often leads to treatment with long-term opioids. Our goal was to describe the pharmaco-toxicological profile of opioid-treated CLBP patients and identify potential areas for care optimization.Design: Cross-sectional analysis.Setting: Outpatient primary care.Participants: CLBP patients prescribed ≥ 30 mg/d of morphine-equivalent dose (MED) for ≥3 months.Outcome Measures: Self-reported clinical, medication (verified) and substance use, and urine drug testing (UDT) data were collected.Results: Participants (N = 35) were 51.8 ± 9.7 years old, 80 percent female with CLBP for 14.2 ± 10.1 years, treated with opioids for 7.9 ± 5.7 years, with severe disability (Oswestry Disability Index score: 66.7 ± 11.4), and average pain score of 5.6 ± 1.5 (0-10 rating scale). Participants reported using tobacco (N = 14), alcohol (N = 9) and illicit drugs or unprescribed medications (N = 10). On average, participants took 13.4 ± 6.8 daily medications, including 4.7 ± 1.8 pain-modulating and 4.7 ± 2.0 sedating medications. Among prescribed opioids, 57.1 percent were long-acting and 91.4 percent were short-acting, with a total of 144.5 ± 127.8 mg/d of MED. Sixteen participants were prescribed benzodiazepines and/or zolpidem/zaleplon. Fifteen participants had UDT positive for illicit drugs or unprescribed medications; in addition, eight tested positive for alcohol and 19 for cotinine. Compared to those with negative UDTs, those with positive UDTs (N = 15) received lower daily “total” and “extended release” opioid doses, and were more likely to test positive for cotinine (p < 0.05).Conclusions: Study findings corroborate existing evidence for high medication burden and high likelihood of substance misuse among opioid-treated CLBP patients. Further research is needed to help understand causality and ways to optimize care and clinical outcomes.


2021 ◽  
pp. 67-72
Author(s):  
V. A. Parfenov ◽  
I. A. Lamkova

Introduction. Kinesitherapy (KT) – one of the leading areas of patient care with chronic nonspecific (musculoskeletal pain) low back pain. For chronic lumbar pain, a standard KT is commonly used, that includes group sessions with a medical specialist. Often not taking into account the individual characteristics of patients, their attitude to KT, does not use a backpain education program in combination with KT (extended KT). Physical activity and hypodynamia are compared in patients with chronic nonspecificlow back pain in standard KT and extended KT.Aim of study is to assess the effectiveness of the standard and extended KT in the enhancement of physical activity.Materials and methods. 71 patients were observed (17 men and 54 women, average age 55.09 ± 13 years) with chronic nonspecific low back pain. Patients received non-steroidal anti-inflammatory drugs (NSAIDs) as painkillers. 34 patients received a standard KT, 37 patients – an extended KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, and the International Physical Activity Questionnaire (IPAQ) at baseline, after 7 days and 90 days.Results and discussion. In the extended KT group, physical activity increased from 11 (7–16) points to 16 (13–19) points after 7 days (p = 0.001) and up to 23 (15–26) points after 3 months (p = 0.0002). There has been a statistically significant decrease in the proportion of patients with hypodynamy (p = 0.0015). There is no statistically significant increase in physical activity in the standard therapy group. The use of NSAIDs in non-specific low back pain is discussed, the effectiveness of the use of dexketoprofen (Dexalgin) during lumbar pain is noted.Conclusion. In the case of nonspecific low back pain, the extended KTimprovesphysical activity and reduce hypodynamy.


2018 ◽  
Vol 24 (1) ◽  
pp. 577-580
Author(s):  
Komal Mushtaq ◽  
Shoaib Waqas ◽  
Hafiz Muhammad Asim

Chronic low back pain (CLBP) can be managed by multidisciplinary team approach especially physiotherapy and rehabilitation. In this study, effectiveness of spinal manual therapy (maitland grade I and II mobilization) for CLBP management was assessed. Methods: All subjects in the study were provided maitland grade I and II spinal mobilization for 20 minutes each. A similar treatment frequency was applied and consisted on three sessions per week for 2 continuous weeks. Numeric pain rating scale (NPRS) was applied to assess the pain severity levels before treatment and after treatment. Data were normally distributed and therefore, change in pain intensity was measured by “t” test using SPSS version 23.0. Results: The calculated mean pain score on NPRS before treatment was 3.90 (standard deviation, 0.3038) and after treatment it was 1.65 (standard deviation, 0.8638). The calculated t-value was 12.08 (p value=0.000). Conclusion: These results clearly demonstrate that the maitland G1 and G2 spinal mobilization can be exploited as an effective treatment choice for chronic low back pain.


2021 ◽  
Vol 71 (9) ◽  
Author(s):  
Mudassar Rooh Ul Muazzam ◽  
Salma Abbas ◽  
Sidra Abbas ◽  
Muhammad Ashar Rafi

AbstractObjective: The purpose of this study was to find out the frequency of low back pain in young adults and its relationship with the mattresses they use.Methodology: This cross sectional study was carried out in 6 months in twin cities (Rawalpindi and Islamabad). The sample size for this study was 366. For data collection, self-structured questionnaire was used along with Modified Oswestry Scale and Numeric Pain Rating Scale (NPRS). The inclusion criteria for this study was young adults with age limit 18-35 years and the participants who used the same kind of mattress for more than 3 months. Post-surgical patients and the patients diagnosed with lumbar pathology were excluded from this study. Data was then analyzed through SPSS statistics 24.Results: Mean age of the participants was 22.06±3.74 years. Majority 208(56.38%) participants were feeling low back pain and out of these 208 participants, Pain was most prevalent 30(68.18%) in firm mattress users followed by 128(59.25%) in foam mattress users. Low back pain was more associated with those participants who were not changing their mattresses for more than three years.Conclusion: Low back pain is frequently present in young adults and more prevalent in those participants who were using same firm or foam mattresses for more than three years.Keywords: Back pain, Mattresses, Posture, and Young Adults. Continuous...


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