scholarly journals Pain Neuroscience Education for Depression: A Pilot Study

2021 ◽  
pp. 1-7
Author(s):  
Adriaan Louw ◽  
Adriaan Louw ◽  
Ellen Wendling ◽  
Dustin Hawk ◽  
Nicole Sturdevant ◽  
...  
Keyword(s):  
Pilot Study ◽  
Rating Scale ◽  
Physical Therapist ◽  
Severe Depression ◽  
Leg Pain ◽  
Low Back ◽  
Post Intervention ◽  
Convenience Sample ◽  
Neuroscience Education ◽  
Pain Knowledge

Objective: To determine if a brief, one-on-one pain neuroscience education (PNE) session delivered by a physical therapist (PT) can influence depression. Methods: A convenience sample of patients with persistent low back pain (LBP) (n = 23) attending PT with moderate to severe depression (Patient Health Questionnaire-9 [PHQ-9]) participated in the study. Patients received a standardized, one-on-one 30-minute PNE session by a PT with pre- and post-intervention measures of low back and leg pain (Numeric Pain Rating Scale [NPRS]), pain catastrophization (Pain Catastrophization Scale [PCS]), pain knowledge (Revised Neurophysiology of Pain Questionnaire [rNPQ] and depression (PHQ-9). Results: Immediately following PNE, all measures improved, with low back and leg pain not being significant (pback = 0.345 and pleg = 0.633), while pain catastrophization (p = 0.047), pain knowledge (p = 0.001) and depression (p = 0.004) reaching significant improvements. The PNE session shifted various patients to lower levels of depression, with 21.8% of the patients’ improvement in depression meeting or exceeding the minimal clinical important difference. Conclusion: PNE may be a safe, clinically effective way to help a subgroup of patients attending PT with depression. More studies are needed to further explore the results from this pilot study.

Effectiveness of duloxetine on severity of pain and quality of life in chronic low back pain in patients who had posterior spinal fixation

2021 ◽  
pp. 221049172098333
Author(s):  
Arezoo Samadi ◽  
Razieh Salehian ◽  
Danial Kiani ◽  
Atefeh Ghanbari Jolfaei
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Rating Scale ◽  
Low Back ◽  
Spinal Fixation ◽  
Post Intervention ◽  
Significant Difference ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

Background: In this study, we want to search the effectiveness of Duloxetine on the severity of pain and quality of life in patients with chronic low back pain who had posterior spinal fixation. Methods: In this randomized, placebo-controlled trial done in 6 months 50 patients who had CLBP and were candidates for PSF surgery selected and divided into two groups (drug and placebo). They filled the VAS, SF-36, and Hamilton questionnaires before surgery and after 6 weeks from using 30 mg of duloxetine or placebo. Results: Significant differences were evidenced among groups for the Visual Analogue Scale (P = 0.005) and Verbal Analogue Scale (p = 0.003). Patients in the Duloxetine group have more visual and verbal pain scores than the placebo group. In the quality of life, there was a significant difference between the two groups before the intervention. Also, significant differences were evidenced among groups for the Hamilton Anxiety Rating Scale (p = 0.17). After the intervention, only the Hamilton Anxiety Rating Scale (p = 0.001) and ‘bodily pain’ and ‘general health’ subscales of quality of life (p = 0.008, 0.004, respectively) have a significant difference between the two groups. There was a significant difference between pre and post-intervention in the Hamilton Anxiety Rating Scale only in the duloxetine group. Also, in terms of quality of life, the subscales of ‘physical role’, ‘emotional role’, ‘physical pain’ and ‘total score of quality of life’ in the duloxetine and placebo groups were significantly different between pre and post-intervention. However, the subscales of ‘physical function’ and ‘general health’ were significantly different only in the duloxetine group between pre and post-intervention. Conclusion: The results suggest that the use of duloxetine in patients who had spinal surgery can help to better control back pain, on the other hand, it can cause a better psychological condition that affects the quality of life.

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 Randomized Clinical Trial Comparing the Effectiveness of Electroacupuncture versus Medium-Frequency Electrotherapy for Discogenic Sciatica

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Xue Zhang ◽  
Yang Wang ◽  
Zhao Wang ◽  
Chao Wang ◽  
Wentao Ding ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Leg Pain ◽  
Secondary Outcome ◽  
Low Back ◽  
Medium Frequency

Objective. To investigate the short- and long-term effects of electroacupuncture (EA) compared with medium-frequency electrotherapy (MFE) on chronic discogenic sciatica.Methods. One hundred participants were randomized into two groups to receive EA (n=50) or MFE (n=50) for 4 weeks. A 28-week follow-up of the two groups was performed. The primary outcome measure was the average leg pain intensity. The secondary outcome measures were the low back pain intensity, Oswestry Disability Index (ODI), patient global impression (PGI), drug use frequency, and EA acceptance.Results. The mean changes in the average leg pain numerical rating scale (NRS) scores were 2.30 (1.86–2.57) and 1.06 (0.62–1.51) in the EA and MFE groups at week 4, respectively. The difference was significant (P<0.001). The long-term follow-up resulted in significant differences. The average leg pain NRS scores decreased by 2.12 (1.70–2.53) and 0.36 (−0.05–0.78) from baseline in the EA and MFE groups, respectively, at week 28. However, low back pain intensity and PGI did not differ significantly at week 4. No serious adverse events occurred.Conclusions. EA showed greater short-term and long-term benefits for chronic discogenic sciatica than MFE, and the effect of EA was superior to that of MFE. The study findings warrant verification. This trial was registered under identifierChiCTR-IPR-15006370.

Stretch-induced hypoalgesia: a pilot study

2020 ◽  
Vol 20 (4) ◽  
pp. 837-845
Author(s):  
Marie-Claude Larouche ◽  
Samuel Camiré Bernier ◽  
Rosalie Racine ◽  
Olivier Collin ◽  
Mikaël Desmons ◽  
...  
Keyword(s):  
Pilot Study ◽  
Repeated Measures ◽  
Pain Sensitivity ◽  
Low Back ◽  
Post Intervention ◽  
Local Site ◽  
Clinical Pain ◽  
Repeated Measures Analysis ◽  
Remote Sites ◽  
Randomised Controlled

AbstractObjectivesStretching is an intervention often used in various kinds of rehabilitation protocols and the effects on pain sensitivity has sparsely been investigated, especially when addressing potential effects on pain. The objective is to investigate the immediate effects of an axial and peripheral prolonged stretch on pressure pain sensitivity (PPT) and temporal summation (TS) on local and distal sites in healthy subjects.MethodsTwenty-two healthy volunteers were recruited to participate in this pilot study. Two prolonged stretching protocols were performed: low back and wrist extensors stretches. PPT and pinprick TS were measured pre- and post-intervention at local and remote sites. Repeated measures analysis of variance (ANOVA) was used to examine the effects and significance of the interventions.ResultsThe low back stretch induced an increase in PPT for both local and remote sites, and the wrist stretch produced a PPT increase only at the local site. TS did not change.ConclusionsLow back stretching induced an increase in PPT at both local and remote sites whereas the wrist stretch only increased PPT locally, suggesting hypoalgesia at these sites. Further studies are needed to confirm the effect and mechanisms using randomised, controlled and parallel study design. Considering that pain sensitivity is different than clinical pain, results are difficult to extrapolate to clinical practice. Future studies testing clinical pain are needed to better understand the clinical implication of these results.

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 Correlation between Pain, Kinesiophobia and Physical Activity Level in Patients with Chronic Low Back Pain Aged between 30 to 50 Years

2021 ◽  
Vol 6 (3) ◽  
pp. 359-365
Author(s):  
Mrunal R. Malewar ◽  
Kartik D. Shah
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Physical Activity Level ◽  
Rating Scale ◽  
Physical Therapist ◽  
Activity Level ◽  
Short Version ◽  
Low Back

Background: Low back pain is one of the most common conditions encountered by a physical therapist in their clinical practice. Chronic low back pain is difficult to treat due to various environmental and psychological factors such as kinesiophobia, which may possibly lead to altered or reduced physical activity level producing various effects on musculoskeletal system. In addition to this, little is known about the relation between these factors, especially in Indian population. Therefore, it is important to find out if any correlation exists between these factors. Methods: This Correlational study included 53 patients of both gender suffering from chronic low back pain. Numerical Pain Rating Scale (NPRS), Marathi version of Tampa Scale of Kinesiophobia (TSK) and short version of International Physical Activity Questionnaire (IPAQ) were administered in the patients after obtaining their consent. The responses were collected and then analyzed using Pearson’s coefficient. Results: The mean pain intensity was found to be 3.11±2.24 and 6.86±1.91 at rest and on activity respectively. Mean score of kinesiophobia was 29.11±5.00. Mean score of physical activity level was 5466.62±5362. Significant correlation was found between pain during activity and kinesiophobia (p<0.05). Conclusion: This study demonstrates significantly positive correlation between pain during activity and kinesiophobia in patients with chronic low back pain aged between 30-50 years. However, no significant correlation was obtained between pain and physical activity level, kinesiophobia and physical activity level. Keywords: Chronic low back pain, Kinesiophobia, Physical activity level, TSK, IPAQ.

scholarly journals Chemonucleolysis with Chondroitin Sulfate ABC Endolyase for Treating Lumbar Disc Herniation: Exploration of Prognostic Factors for Good or Poor Clinical Outcomes

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 627 ◽  
Author(s):  
Katsuhiko Ishibashi ◽  
Muneyoshi Fujita ◽  
Yuichi Takano ◽  
Hiroki Iwai ◽  
Hirohiko Inanami ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chondroitin Sulfate ◽  
Clinical Outcomes ◽  
High Intensity ◽  
Rating Scale ◽  
Leg Pain ◽  
Intensity Change ◽  
Low Back ◽  
Score Improvement

Background and Objectives: Chondroitin sulfate ABC endolyase (condoliase) was launched as a new drug for chemonucleolysis in 2018. Few studies assessed its clinical outcomes, and many important factors remain unclear. This study aimed to clarify the preoperative conditions in which condoliase could be highly effective. Materials and Methods: Of 47 patients who received condoliase, 34 were enrolled in this study. The mean age of the patients was 33 years. The average duration since the onset of disease was 8.6 months. We evaluated patients’ low back and leg pain using a numerical rating scale (NRS) score at two time points (before therapy and 3 months after therapy). We divided the patients into two groups (good group (G): NRS score improvement ≥ 50%, poor group (P): NRS score improvement < 50%). The parameters evaluated were age, disease duration, body mass index (BMI), and positive or negative straight leg raising test results. In addition, the loss of disc height and preoperative radiological findings were evaluated. Results: In terms of low back and leg pain, the G group included 9/34 (26.5%) and 21/34 (61.8%) patients, respectively. Patients’ age (low back pain G/P, 21/36.5 years) was significantly lower in the G group for low back pain (p = 0.001). High-intensity change in the protruded nucleus pulposus (NP) and spinal canal occupancy by the NP ≥ 40% were significantly high in those with leg pain in the G groups (14/21, p = 0.04; and 13/21, p = 0.03, respectively). Conclusions: The efficacy of improvement in leg pain was significantly correlated with high-intensity change and size of the protruded NP. Condoliase was not significantly effective for low back pain but could have an effect on younger patients.

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