Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial

2021 ◽  
pp. 109980042110448
Author(s):  
Vajihe Ghavipanje ◽  
Nasser Mohammad Rahimi ◽  
Farideh Akhlaghi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Hold Time ◽  
Breath Hold ◽  
Postpartum Women ◽  
Global Rating ◽  
Low Back ◽  
Fear Avoidance Beliefs

Background: The worldwide prevalence of obesity and low back pain (LBP) has recently dramatically increased and is mainly indicated among postpartum women, leading to a range of adverse health consequences. Objective: This study aimed to investigate the effects of 6 weeks of Dynamic Neuromuscular Stabilization training (DNS) in obese postpartum women with LBP. Method: This was a pretest-posttest study design. The study was conducted with 40 obese postpartum women with LBP randomized to receive DNS ( n = 20) or General Exercise (GE, n = 20) 6 times a week for 6 weeks. The data were gathered before and after the 6-week intervention. Results: Forty participants completed the study (mean ± SD, age 29.30 ± 3.77 years; weight 88.10 ± 6.09 kg; height 165.40 ± 6.31 cm; and BMI, 32.19 ± 1.07 kg/m2). The overall group-by-time interaction was significant for Numeric Pain-Rating Scale, Modified Oswestry Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire, Inspiration and Expiration Breath Hold Time, and Respiratory Rate outcomes. The global rating of change was significantly different between groups ( p < .05). The rate of improvement was higher in the DNS group compared to the GE group in all 6 tests. Conclusion: The present study confirms that DNS is applicable in obese postpartum women with LBP and effectively improved NPRS, MODQ, FABQ, BHT, and RR. It is clinically suggested that DNS is imperative based on ideal ontogenetic patterns to attain optimal results for obese postpartum women with LBP.

scholarly journals Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial

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
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Cross Sectional ◽  
Toxicological Profile

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.

Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial

2020 ◽  
Vol 29 (2) ◽  
pp. 179-185 ◽  
Author(s):  
TaeYeong Kim ◽  
JaeHyuk Lee ◽  
SeJun Oh ◽  
Seungmin Kim ◽  
BumChul Yoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Oswestry Disability Index ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Low Back ◽  
Baseline Values ◽  
Numeric Rating

Context: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Design: A randomized controlled trial. Settings: Community and university campus. Participants: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Interventions: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. Main Outcome Measures: Numeric rating scale, functional disabilities (Oswestry disability index and Roland–Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. Results: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland–Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland–Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. Conclusions: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.

Effects on Brain Correlates and Psychological Functioning of a Mobile Application (BackFit App) Based on Education and Therapeutic Exercise among Patients with Non-specific Chronic Low Back Pain: A Non-randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Carolina Sitges ◽  
Juan Lorenzo Terrasa ◽  
Nuria García-Dopico ◽  
Joan Segur-Ferrer ◽  
Olga Velasco-Roldán ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Power Density ◽  
Psychological Functioning ◽  
Flanker Task ◽  
Controlled Trial ◽  
Low Back ◽  
Pressure Pain ◽  
Fear Avoidance Beliefs ◽  
Face To Face

BACKGROUND Low back pain is the main cause of disability in industrialized countries, causing suffering of patients and public health expenditure in care and labor concepts. However, current interventions are inadequate because are often based on a biomedical model. To improve the efficacy of current interventions in chronic low back pain (CLBP) it is necessary to apply knowledge about brain mechanisms involved in pain processing and increase evidence about innovative mobile health applications. OBJECTIVE To investigate if a self-managed program based on education and therapeutic exercise using a mobile application (“BackFit App”), compared to a face-to-face supervised program, produces changes in brain and heart activity, pain and disability, pain sensitivity, psychological and cognitive functioning. METHODS A 2-arm parallel non-randomized controlled trial was conducted. Fifty patients with non-specific CLBP participated in an educational and exercise-based 4-weeks intervention. They were assigned to a self-managed (using BackFit App) (n=23, mean 45.00 [SD 9.13] years, 10 males) or a face-to-face intervention group (n=27, mean 48.63 [SD 7.54] years, 7 males). All measures were assessed at the Research Institute of Health Sciences (IUNICS) located at University of Balearic Islands (Palma, Spain). Primary outcomes were electroencephalographic (EEG) (at rest and during a modified version of the Eriksen Flanker Task) and electrocardiographic (ECG) activity (at rest). Secondary outcomes were pressure pain thresholds and pressure pain intensity ratings, psychological functioning (mood, anxiety, kinesiophobia, pain catastrophizing, fear-avoidance beliefs) and cognitive performance (percentage of hits, reaction times). RESULTS Both groups were comparable in terms of gender, age, anthropometrics, systolic and diastolic blood pressure, pain duration, handedness and anxiety (all P>.05). Frequency analysis of EEG resting-state data showed increased beta-2 (.0020 vs .0024, P = .027) and beta-3 (.0013 vs .0018, P = .035) after the intervention. Source analyses also revealed significant higher power density of beta (16-30 Hz) at anterior cingulate cortex (ACC) after the intervention, but additionally higher power density of alpha (8-12 Hz) at postcentral gyrus and lower power density of delta (2-4 Hz) at cuneus and precuneus (all P<.05). Both groups also improved depression (7.74 vs 5,15, P=.012), kinesiophobia (22.91 vs 20.87, P=.002) (and activity avoidance (14.49 vs 12.86, P<.001)), helplessness (6.38 vs 4.74, P=.027), fear avoidance beliefs (35 vs 29.11, P=.031) (and avoidance to physical activity (12.07 vs 9.28, P=.011)), but increased disability (6.08 vs 7.5, P=.014), scores after the intervention. No significant differences between groups nor sessions were found in ECG resting-state data, EEG data during the Flanker Task, cognitive performance nor pain sensitivity (all P>.05). CONCLUSIONS Both intervention modalities increased beta activity at rest, mainly located at ACC, and improved psychological functioning. Future studies that consider longer duration and individualization of the intervention program, and that include CLBP patients with greater pain and disability baselines should be conducted. CLINICALTRIAL ClinicalTrials.gov NCT04576611.

scholarly journals A randomised controlled trial of ‘clockwise’ ultrasound for low back pain

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Adriaan Louw ◽  
Kory Zimney ◽  
Merrill R. Landers ◽  
Mark Luttrell ◽  
Bob Clair ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Control Group ◽  
Low Back ◽  
Lumbar Flexion ◽  
Experimental Group

Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or exceeding minimal detectable changes (MDCs) for pain, lumbar flexion and SLR.Results: Both EG and EEG groups showed a statistically significant improvement for SLR (p < 0.0001), while the CG did not. The EEG group participants were 4.4 times (95% confidence interval: 1.1 to 17.5) more likely to improve beyond the MDC than the CG. No significant differences were found between the groups for LBP, leg pain or lumbar flexion.Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment.

scholarly journals A Preliminary Study of the Objective Measurement of Compliance Rates for Semirigid Lumbar-Support Use in Patients with Chronic Nonspecific Low Back Pain: How Important Is the Compliance Rate?

2017 ◽  
Vol 11 (5) ◽  
pp. 748-755 ◽  
Author(s):  
Maryam Hekmatfard ◽  
Mohammad Ali Sanjari ◽  
Nader Maroufi ◽  
Hassan Saeedi ◽  
Esmail Ebrahimi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Compliance Rate ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Lumbar Support ◽  
Mean Compliance

<sec><title>Study Design</title><p>Clinical pilot study.</p></sec><sec><title>Purpose</title><p>To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs.</p></sec><sec><title>Overview of Literature</title><p>Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects.</p></sec><sec><title>Methods</title><p>Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire.</p></sec><sec><title>Results</title><p>The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (<italic>p</italic>=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (<italic>p</italic>&lt;0.001, <italic>p</italic>=0.02, respectively).</p></sec><sec><title>Conclusions</title><p>The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.</p></sec>

scholarly journals Efficacy of electroacupuncture in patients with failed back surgery syndrome: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaoping Sheng ◽  
Hongyu Yue ◽  
Qi Zhang ◽  
Deta Chen ◽  
Weidong Qiu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Failed Back Surgery Syndrome ◽  
Low Back ◽  
Randomized Controlled ◽  
Failed Back Surgery ◽  
Back Surgery

Abstract Background Persistent pain following back surgery called failed back surgery syndrome remains a major treatment challenge. The aim of this study is to evaluate the efficacy and safety of electroacupuncture on relieving back pain in FBSS patients. Methods/design This is a randomized, single-blind, single-site, placebo-controlled trial. A total of 144 eligible FBSS patients will be randomly assigned to the electroacupuncture, manual acupuncture, or sham acupuncture group in a 1:1:1 ratio. Each group will receive 2 treatment sessions per week for 12 weeks. The primary outcome will be low back pain intensity based on the 11-point numerical rating scale (NRS). The secondary outcomes include Oswestry Disability Index (ODI) questionnaire, Beck Depression Inventory-II (BDI-II), Pittsburgh Sleep Quality Index (PSQI), and analgesic consumption. All clinical outcomes will be collected at baseline, during the treatment phase (at 8 and 12 weeks), and at the 16-, 24- and 36-week follow-ups. All data will be analyzed based on the intention-to-treat principle and adverse events will be assessed during the trial. Discussion This pilot randomized controlled trial will evaluate the efficacy of electroacupuncture for treating failed back surgery syndrome. The outcomes will determine whether electroacupuncture is efficacious in relieving low back pain as well as improving the quality of life in failed back surgery syndrome patients. Trial registration Chinese Clinical Trial Registry ChiCTR2000040144. Registered on 22 November 2020

scholarly journals Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain

2021 ◽  
Vol 3 (1) ◽  
pp. 24-31
Author(s):  
Faria Aqil ◽  
Muhammad Affan Iqbal ◽  
Suhail Karim ◽  
Muhammad Umar Iqbal ◽  
Muhammad Junaid Akram ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Post Intervention ◽  
Lumbar Stabilization ◽  
Numeric Pain Rating Scale

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material & Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

scholarly journals Epidural triamcinolone for management of low back pain with radiation- a comparative study of two dose regime

2014 ◽  
Vol 23 (1) ◽  
pp. 14-18
Author(s):  
Md Mustafa Kamal ◽  
Abdullah Al Maruf ◽  
Md Shahadat Hossain ◽  
Md Abdus Samad ◽  
Md Hasanuzzaman ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Dose ◽  
Rating Scale ◽  
Controlled Trial ◽  
Significant Rise ◽  
High Dose ◽  
Low Back ◽  
Significant Difference ◽  
Acceptable Method

Background: Low back pain is a very common specially in elderly people. Relief of pain is associated with decrease in morbidity, shorten hospital stay and increase patients’ satisfaction. Nerve block by epidural steroid and local anaesthetic is an acceptable method to reduce low back pain. Aim and objective: The present study was performed to compare low dose (40 mg) and high dose (80 mg) Triamcinolone to see their effectiveness and side effects in controlling low back pain. Method: This study was a randomized controlled trial. 60 patients with low back pain with radiation, and with positive CT/MRI support has been randomly selected by blind envelop method and divided into two groups, 30 patients in each. Group-A, patients received inj. Triamcinolone (40 mg) and Group-B patients received inj. Triamcinolone (80 mg) epidurally. Results: Both dosage produced effective analgesia in low back pain as assessed by visual analogue scale (VAS) and verbal rating scale (VRS) for the period up to 30 days after administration. Haemodynamic changes showed no significant difference between the two drugs after 30 days. Both drugs produced significant rise of fasting plasma glucose and leucocytosis for the period up to 30 days after administration. Conclusion: Low back pain can be effectively reduced by epidural low dose Triamcinolone (40 mg). DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18153 Journal of BSA, 2010; 23(1): 14-18

scholarly journals Efficacy and safety of treating chronic nonspecific low back pain with radial extracorporeal shock wave therapy (rESWT), rESWT combined with celecoxib and eperisone (C+E) or C+E alone: a prospective, randomized trial

2020 ◽  
Author(s):  
Xuejiao Guo ◽  
Lin Li ◽  
Zhe Yan ◽  
Yunze Li ◽  
Zhiyou Peng ◽  
...  
Keyword(s):  
Shock Wave ◽  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Level Of Evidence ◽  
Extracorporeal Shock Wave

AbstractBackgroundTo investigate whether respectively radial extracoporeal shock wave therapy (rESWT) or a combination of rESWT, Celecoxib and Eperisone (rESWT+C+E) are superior in reducing pain in subjects with chronic nonspecific low back pain (cnsLBP) compared to C+E alone (a standard treatment of this condition in China).Methods140 subjects with cnsLBP were randomly allocated to rESWT (n=47), rESWT+C+E (n=45) or C+E alone (n=48) for four weeks. Outcome was evaluated using the Pain Self-Efficacy Questionnaire (PSEQ), Numerical Rating Scale (NRS), Oswestry Low Back Pain Disability Questionnaire and Patient Health Questionnaire 9, collected at one week (W1), W2, W3, W4 and W12 after beginning of the therapy.ResultsAll scores showed a statistically significant improvement over time. The PSEQ and NRS scores showed a significant Time × Treatment effect. Subjects treated with rESWT had significantly lower mean NRS values than subjects treated with rESWT+C+E at W1 and W3, as well as than subjects treated with C+E alone at W3 and W4. No severe adverse events were observed.ConclusionrESWT may be superior to respectively rESWT+C+E or C+E alone in reducing pain in subjects with cnsLBP. Level of Evidence: Level I, prospective, randomized, active-controlled trial.

scholarly journals Cryoneurolysis’ outcome on pain experience (COPE) in patients with low-back pain: study protocol for a single-blinded randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K. Truong ◽  
K. Meier ◽  
L. Nikolajsen ◽  
M. W. van Tulder ◽  
J. C.H Sørensen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Joint Pain ◽  
Rating Scale ◽  
Facet Joint ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Low Back ◽  
Registration Number ◽  
Facet Joint Pain

Abstract Background Low-back pain, including facet joint pain, accounts for up to 20 % of all sick leaves in DenmarkA proposed treatment option is cryoneurolysis. This study aims to investigate the effect of cryoneurolysis in lumbar facet joint pain syndrome. Methods A single-center randomized controlled trial (RCT) is performed including 120 participants with chronic facet joint pain syndrome, referred to the Department of Neurosurgery, Aarhus University Hospital. Eligible patients receive a diagnostic anesthetic block, where a reduction of pain intensity ≥ 50 % on a numerical rating scale (NRS) is required to be enrolled. Participants are randomized into three groups to undergo either one treatment of cryoneurolysis, radiofrequency ablation or placebo. Fluoroscopy and sensory stimulation is used to identify the intended target nerve prior to administrating the above-mentioned treatments. All groups receive physiotherapy for 6 weeks, starting 4 weeks after treatment. The primary outcome is the patients’ impression of change in pain after intervention (Patient Global Impression of Change (PGIC)) at 4 weeks follow-up, prior to physiotherapy. Secondary outcomes are a reduction in low-back pain intensity (numeric rating scale) and quality of life (EQ-5D, SF-36) and level of function (Oswestry Disability Index), psychological perception of pain (Pain Catastrophizing Scale) and depression status (Major Depression Inventory). Data will be assessed at baseline (T0), randomization (T1), day one (T2), 4 weeks (T3), 3 (T4), 6 (T5) and 12 months (T6). Discussion This study will provide information on the effectiveness of cryoneurolysis vs. the effectiveness of radiofrequency ablation or placebo for patients with facet joint pain, and help to establish whether cryoneurolysis should be implemented in clinical practice for this patient population. Trial registration The trial is approved by the ethical committee of Central Jutland Denmark with registration number 1-10-72-27-19 and the Danish Data Protection Agency with registration number 666,852. The study is registered at Clinicaltrial.gov with the ID number NCT04786145.

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