The contemporary management of nonspecific lower back pain

2019 ◽  
Vol 9 (5) ◽  
pp. 475-482 ◽  
Author(s):  
Ronaldo Fernando de Oliveira ◽  
Junior Vitorino Fandim ◽  
Iuri Fioratti ◽  
Lívia Gaspar Fernandes ◽  
Bruno Tirotti Saragiotto ◽  
...  

Low back pain (LBP) is extremely common and causes an enormous burden on the society. This perspective article aims to provide an evidence-based summary in the field of LBP. More specifically, we aimed to present epidemiological data on cost, diagnosis, prognosis, prevention and interventions for patients with LBP. It is critical that both clinicians and policymakers follow best practices by using high-value care for patients with LBP. In addition, nonevidence-based procedures must be immediately abandoned. These actions are likely to reduce societal costs and will improve the quality of life of these patients.

2021 ◽  
Vol 10 (4) ◽  
pp. 3244-3248
Author(s):  
Shruti Desphande

The literature defines DRA as a gap of more than two fingerbreadths between two rectal abdominal muscle bellies, either above or below the umbilicus. Separation is referred to as DRA. Female diastasis recti is more common in postpartum women. Lower back pain is the most common cause of daily activity limitation in postpartum females. Post-partum women express concerns about their mobility, pain, and normal activities, all of which have an impact on an individual's quality of life. The study aimed to check the Impact of diastasis recti and low back pain on quality of life in post-partum females. This research will be conducted at the Physiotherapy OPD at Ravi Nair Physiotherapy College and the AVBRH in Sawangi (Meghe), Wardha. Post-partum females will be evaluated for diastasis recti. The effect of diastasis recti and low back pain on postpartum females' quality of life. The current study significantly showed that the correlation between diastasis recti and quality of life with satisfaction is -0.473r, and the correlation between diastasis recti and importance is -0.452r, and the correlation between low back pain and quality of life is 0.025r.So the present study shows that an increase in inter rectal distance and low back pain will affect the quality of life in postpartum females. From the present study, we can conclude that an increase in rectal distance and lower back pain have an impact on the quality of life of postpartum females.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kyle Auger ◽  
Gregory Shedlock ◽  
Kasey Coutinho ◽  
Nicole E. Myers ◽  
Santiago Lorenzo

Abstract Context Lower back pain (LBP) is prevalent and is a leading contributor to disease burden worldwide. Osteopathic manipulative treatment (OMT) can alleviate alterations in the body that leads to musculoskeletal disorders such as LBP. Bio-electromagnetic Energy Regulation (BEMER; BEMER International AG), which has also been shown to relieve musculoskeletal pain, is a therapeutic modality that deploys a biorhythmically defined stimulus through a pulsed electromagnetic field (PEMF). Therefore, it is possible that combined OMT and BEMER therapy could reduce low back pain in adults more than the effect of either treatment modality alone. Objectives To investigate the individual and combined effects of OMT and BEMER therapy on LBP in adults. Methods Employees and students at a medical college were recruited to this study by email. Participants were included if they self-reported chronic LBP of 3 months’ duration or longer; participants were excluded if they were experiencing acute LBP of 2 weeks’ duration or less, were currently being treated for LBP, were pregnant, or had a known medical history of several conditions. Ultimately, 40 participants were randomly assigned to four treatment groups: an OMT only, BEMER only, OMT+BEMER, or control (light touch and sham). Treatments were given regularly over a 3 week period. Data on LBP and quality of life were gathered through the Visual Analog Scale (VAS), Short Form 12 item (SF-12) health survey, and Oswestry Low Back Pain Questionnaire/Oswestry Disability Index prior to treatment and immediately after the 3 week intervention protocol. One-way analysis of variance (ANOVA) was performed retrospectively and absolute changes for each participant were calculated. Normal distribution and equal variances were confirmed by Shapiro–Wilk test (p>0.05) and Brown-Forsythe, respectively. Significance was set at p<0.05. Results Despite a lack of statistical significance between groups, subjective reports of pain reported on the VAS showed a substantial mean percentage decrease (50.8%) from baseline in the OMT+BEMER group, compared with a 10.2% decrease in the OMT-only and 9.8% in BEMER-only groups when comparing the difference in VAS ratings from preintervention to postintervention. Participants also reported in quality of life assessed on the Oswestry Low Back Pain Questionnaire/Oswestry Disability Index, with the OMT+BEMER group showing a decrease of 30.3% in score, the most among all groups. The OMT+BEMER group also reported the greatest improvement in score in the physical component of the SF-12, with an increase of 21.8%. Conclusions The initial data from this study shows a potential additive effect of combination therapy (OMT and BEMER) for management of LBP, though the results did not achieve statistical significance.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
José W. Geurts ◽  
Paul C. Willems ◽  
Jan-Willem Kallewaard ◽  
Maarten van Kleef ◽  
Carmen Dirksen

Introduction. Chronic discogenic low back pain (CDP) is frequently diagnosed in patients referred to specialized pain clinics for their back pain. The aim of this study is to assess the impact of CDP both on the individual patient and on society. Materials and Methods. Using the baseline records of 80 patients in a randomized trial assessing the effectiveness of a new intervention for CDP, healthcare and societal costs related to back pain are calculated. Furthermore, the impact of the condition on perceived pain, disability, health-related quality of life, Quality of life Adjusted Life Years (QALY), and QALY loss is assessed. Results. Using the friction costs approach, we found that the annual costs for society are €7,911.95 per CDP patient, 51% healthcare and 49% societal costs. When using the human capital approach, total costs were €18,940.58, 22% healthcare and 78% societal costs. Healthcare costs were mainly related to pain treatment. Mean pain severity was 6.5 (0–10), and 46% suffered from severe pain (≥7/10). Mean physical limitations rate was 43.7; 13.5% of the patients were very limited to disabled. QALY loss compared to a healthy population was 64%. Discussion. This study shows that in patients with CDP referred to a pain clinic, costs for society are high and the most used healthcare resources are pain therapies. Patients suffer severe pain, are physically limited, and experience a serious loss in quality of life.


Author(s):  
Yen-Mou Lu ◽  
Chung-Hwan Chen ◽  
Yi-Jing Lue

BACKGROUND: Sex and gender affect responses to pain, but little is known about disability and quality of life. OBJECTIVES: To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain. METHODS: Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation. RESULTS: Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains. CONCLUSION: Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.


2020 ◽  
Vol 39 (04) ◽  
pp. 300-305
Author(s):  
Ana Carla Schimidt ◽  
Paula de Oliveira Herzinger ◽  
Danielle Pacheco Matias ◽  
Leonardo C. Welling

AbstractLow back pain is defined as pain located between the lower rib cage and the gluteal folds, and its etiology is multifactorial, considerably affecting quality of life. The aim of this literature review was to analyze the influence of the Pilates method on the symptoms of patients with nonspecific low back pain, which is considered a promising treatment for this type of pathology. A narrative review of the literature was carried out using the PubMed, Pedro, Scopus and Scielo databases. To perform the search, Pilates AND Low back nonspecific AND Pain were used as keywords. Articles published in the last 5 years, randomized clinical trials that verified the influence of the Pilates method in adult individuals with unspecified low back pain and full text in English were included. Of the 77 articles identified, 7 articles met the inclusion criteria, 7 analyzed the primary outcomes of pain intensity and disability, 5 articles compared Pilates with other rehabilitation techniques and 2 studies compared the effectiveness of Pilates solo with Pilates apparatus. It was concluded that all the techniques that were compared with Pilates are effective, being difficult to affirm the superiority of Pilates over them in relation to the reduction of pain and disability and improvement of quality of life. However, the Pilates method has shown good results in pain perception and intensity, functional capacity, fear of movement and the idea that movement can worsen your condition, muscle strength, range of motion and flexibility.


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