Subgrouping patients with chronic low back pain: What are the differences in actual daily life behavior between patients classified as avoider or persister?

Background: The chronic low back pain (LBP) had been considered an important occupational disorder with several strategy available to treatment, however, few studies had been evaluated the treatment combination. Objectives: The aim of present study was compared the effects of combination of crocheting associated to Kinesiotherapy treatment and Kinesiotherapy isolated treatment on function of lumbar spine and pain during achievement of daily life in patients with chronic LBP. Methods: Forty subjects were distributed randomly in two groups: Crochetagem + Kinesioterapy (C; n: 18; 47.5 ± 7.75 years) and Kinesiotherapy (K, n: 18; 45.3 ± 8.93 years). The C group was treated by crocheting technique associated with kinesiotherapy using therapeutic ball. The K group performed a kinesiotherapy treatment using just a therapeutic ball. The following parameters were evaluated: abdominal strength, articular range motion and the data of Rolland Morris and Oswestry Disability Index questionnaires were evaluated before and after 8 weeks of treatment. Both groups performed all therapeutic sessions for 50 minutes, three times a week. Results: Significant differences (p<0.05) were found just on time to trunk flexion and extension, right and left lateral trunk, pain and abdominal strength. However, significant differences on time (p<0.05) was found on Rolland Morris and Oswestry data questionaries parameters just on C group, additionally the values of C group were lower than K group after treatment. Conclusion: Both kinesiotherapy isolated and association of crocheting and kinesiotherapy were useful to improve functional parameters, however the data from Rolland Morris and Oswestry questionaries were lower just on crocheting associated to kinesiotherapy group indicating increment on function of lumbar spine and decrease on pain during achievement of daily life.

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Physicians Experience with and Expectations of the Safety and Tolerability of WHO-Step III Opioids for Chronic (Low) Back Pain: Post Hoc Analysis of Data from a German Cross-Sectional Physician Survey

Pain Research and Treatment ◽

10.1155/2015/745048 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8

Author(s):

Michael A. Ueberall ◽

Alice Eberhardt ◽

Gerhard H. H. Mueller-Schwefe

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Daily Life ◽

Daily Practice ◽

Low Back ◽

Cross Sectional ◽

Post Hoc Analysis ◽

Analgesic Effects ◽

Post Hoc

Objective. To describe physicians’ daily life experience with WHO-step III opioids in the treatment of chronic (low) back pain (CLBP). Methods. Post hoc analysis of data from a cross-sectional online survey with 4.283 Germany physicians. Results. With a reported median use in 17% of affected patients, WHO-step III opioids play a minor role in treatment of CLBP in daily practice associated with a broad spectrum of positive and negative effects. If prescribed, potent opioids were reported to show clinically relevant effects (such as ≥50% pain relief) in approximately 3 of 4 patients (median 72%). Analgesic effects reported are frequently related with adverse events (AEs). Only 20% of patients were reported to remain free of any AE. Most frequently reported AE was constipation (50%), also graded highest for AE-related daily life restrictions (median 46%). Specific AE countermeasures were reported to be necessary in approximately half of patients (median 45%); nevertheless AE-related premature discontinuation rates reported were high (median 22%). Fentanyl/morphine were the most/least prevalently prescribed potent opioids mentioned (median 20 versus 8%). Conclusion. Overall, use of WHO-step III opioids for CLBP is low. AEs, especially constipation, are commonly reported and interfere significantly with analgesic effects in daily practice. Nevertheless, beneficial effects outweigh related AEs in most patients with CLBP.

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