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1.
Praxis (Bern 1994) ; 109(2): 87-95, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32019459

RESUMO

Everyone Has Low Back Pain: Degenerative Lumbar Spinal Disorders and Their Treatment Options Abstract. Back pain is one of the most widespread diseases. Up to 84 % of people have low back pain at some point in their lives. Unspecific back pain is treated conservatively. As supportive measure, interventional pain therapy can be performed. Surgery for low back pain should be considered in selected cases only. However, accompanying neurological symptoms are frequent, such as radiation, i.e. sciatica. Typical etiologies are disc herniation or - increasingly frequent, and due to the aging population increasingly frequent - spinal canal stenosis. Surgery has a better prognosis in cases where conservative management failed. If severe neurological symptoms are present, surgery is indicated. Osteoporotic compression fractures cause acute back pain. The decision whether these patients should undergo kypho- or vertebroplasty should be based on guidelines.


Assuntos
Dor Lombar , Doenças da Coluna Vertebral , Estenose Espinal , Idoso , Humanos , Dor Lombar/etiologia , Dor Lombar/terapia , Vértebras Lombares , Prognóstico , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/terapia , Estenose Espinal/complicações , Estenose Espinal/terapia
2.
Med Clin North Am ; 104(2): 279-292, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035569

RESUMO

Neck pain is the fourth leading cause of disability. Acute neck pain largely resolves within 2 months. History and physical examination play a key role in ruling out some of the more serious causes for neck pain. The evidence for pharmacologic interventions for acute and chronic musculoskeletal neck pain is limited. Lower back pain is the leading cause of disability and productivity loss. Consultation with a physical medicine and rehabilitation spine specialist within 48 hours for acute pain and within 10 days for all patients with lower back pain may significantly decrease rate of surgical interventions and increase patient satisfaction.


Assuntos
Dor Lombar , Cervicalgia , Administração dos Cuidados ao Paciente/métodos , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Cervicalgia/diagnóstico , Cervicalgia/terapia , Prognóstico , Tempo para o Tratamento
3.
Medicine (Baltimore) ; 99(3): e17318, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011431

RESUMO

BACKGROUND: Pregnancy-related low back pain (PLPB) and pelvic pain (PP) are common in pregnancy. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Women commonly utilize complementary exercise therapies such as yoga, motor control exercises, breathing exercises, core stability exercise, pelvic stability exercise, and so on to manage their symptoms. However, it is currently unknown whether exercise produces more beneficial effects than other treatment in patients with PLPB and PP. The aim of this study is to explore the therapeutic effect of exercise for pregnancy-related low back pain and PP. METHODS: This review will only include randomized controlled trials. Published articles from July 1999 to July 2019 will be identified using electronic searches. Search strategy will be performed in 3 English databases, 1 Chinese database, and the World Health Organization International Clinical Trials Registry Platform. Two reviewers will screen, select studies, extract data, and assess quality independently. The methodological quality including the risk of bias of the included studies will be evaluated using a modified assessment form, which is based on Cochrane assessment tool and Physiotherapy Evidence Database scale. Review Manager Software (Revman5.3) will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. We will use GRADE system to evaluate the quality of our evidence. RESULTS: We will provide some more practical and targeted results investigating the effect of exercise therapy (ET) for PLPB and PP in the current meta-analysis. Meanwhile, we will ascertain study progress of ET for PLPB and PP and find out defects or inadequacies of previous studies, so that future researchers could get beneficial guidance for more rigorous study. CONCLUSION: The stronger evidence about PLPB and PPs rehabilitative effect and safety will be provided for clinicians and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD 42017075099.


Assuntos
Terapia por Exercício/métodos , Dor Lombar/terapia , Dor Pélvica/terapia , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Fatores de Tempo
4.
Medicine (Baltimore) ; 99(6): e18860, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028396

RESUMO

RATIONALE: Coccyx fracture is an injury usually caused by trauma. In most cases, the fractures recover after conservative therapy. For refractory cases that exhibit coccydynia after more than 2 months of conservative treatment, coccygectomy is indicated. However, limited information about the efficacy of this procedure is available, and it is known to have a high complication rate. As such, other therapeutic approaches are needed. Here, we report our experience using another conservative treatment option, low-level laser therapy, to successfully reduce refractory coccydynia in a patient with coccyx fracture. PATIENT CONCERNS: A 23-year-old woman had refractory coccydynia and increased pain after a traffic accident-induced coccyx fracture. DIAGNOSES: Initially, the patient reported transient improvement after conservative treatment with non-steroidal anti-inflammatory drugs. However, the pain increased in severity (numerical rating scale score of 8) soon after she resumed work in her office, and progressed in the following 2 months. Surgical intervention was suggested owing to the prolonged coccydynia following the failure of conservative treatment and difficulties in performing daily life activities. However, she sought other conservative therapy options, because she was concerned about the risks associated with the coccygectomy surgery. INTERVENTIONS: The patient received low-level laser therapy once a week, for 24 weeks. OUTCOMES: After 11 weeks of treatment, the patient reported significant improvements in her symptoms; her pain was reduced to a numerical rating scale score of 2 and bone healing was noted on radiographs. The patient could eventually perform her daily activities satisfactorily, without coccydynia, after 24 weeks of treatment. LESSONS: Laser acupuncture produced analgesic effects in this patient with refractory coccydynia after traumatic coccyx fracture. This is the first case report to apply laser acupuncture for refractory coccydynia after traumatic coccyx fracture. Our findings imply that laser acupuncture may be a good conservative therapy option for coccyx fracture.


Assuntos
Cóccix/lesões , Dor Lombar/terapia , Fraturas da Coluna Vertebral/complicações , Terapia por Acupuntura , Feminino , Humanos , Dor Lombar/etiologia , Terapia com Luz de Baixa Intensidade , Medição da Dor , Resultado do Tratamento , Adulto Jovem
5.
Zhongguo Zhen Jiu ; 40(1): 17-20, 2020 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-31930893

RESUMO

OBJECTIVE: To compare the therapeutic effect of thunder-fire moxibustion combined with vibration training and simple vibration training on low back pain of primary osteoporosis by Young's modulus of ultrasonic wave, and seek an objective evaluating method. METHODS: A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. The patients in the two groups were treated with vibration training using whole body vibration treatment bed. In the observation group, thunder-fire moxibustion was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Ganshu (BL 18), Shenshu (BL 23) and Dachangshu (BL 25). The treatment was given once every other day, 3 times a week for 4 weeks. The visual analogue score (VAS), real-time shear wave elastography (RTSWE) and medical outcomes study 36-item short-form hearth survey (SF-36) were used to evaluate pain intensity, multifidus muscle tone (Young's modulus) and quality of life before treatment, after 4-week treatment and 1 month after treatment. RESULTS: Compared before treatment, the VAS scores, Young's modulus of multifidus muscle and 5 dimensions of SF-36 (physical condition, body pain, general health, social function and mental health) after 4-week treatment and 1 month after treatment were significantly improved in the two groups (all P<0.05), the physiological role in the observation group after 4-week treatment and 1 month after treatment were improved (both P<0.05). In the observation group, the VAS scores, Young's modulus of multifidus muscle and 3 dimensions of SF-36 (physiological role, body pain and general health) after 4-week treatment and 1 month after treatment were superior to the control group (all P<0.05). CONCLUSION: The therapeutic effect of thunder-fire moxibustion combined with vibration training is superior to simple vibration training in relieving low back pain intensity and multifidus muscle tone, and improving quality of life for primary osteoporosis. RTSWE technique can be an objective examination method to evaluate pain.


Assuntos
Dor Lombar , Moxibustão , Osteoporose , Pontos de Acupuntura , Humanos , Dor Lombar/etiologia , Dor Lombar/terapia , Osteoporose/complicações , Qualidade de Vida , Resultado do Tratamento , Vibração
6.
World Neurosurg ; 133: e658-e665, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31574335

RESUMO

BACKGROUND: Recurrent and chronic low back pain, caused by degenerative lumbar spondylosis, commonly affects elderly patients, even those with no previous low back surgery. These patients, like those affected by failed back surgery syndrome (FBSS), may become unresponsive to medical conservative treatment and their quality of life could be easily compromised. Moreover, general comorbidities, obesity, and other typical conditions of the elderly may make surgery under general anesthesia riskier than the natural history of the disease. These patients could be considered affected by surgical back risk syndrome (SBRS). METHODS: In this article, we report our preliminary observational prospective study on the role of spinal cord stimulation (SCS) in 3 groups of patients: the FBSS group, the SBRS group, and the "other" group. Selection criteria, treatment modality, and outcomes for each patient group are described and discussed. Moreover, a potentially useful diagnostic and therapeutic flowchart on the management options for lumbar back diseases is discussed. RESULTS: The FBSS group included 25 patients, the SBRS group included 10 patients, and the other group included 3 patients. In 22/25 patients with FBSS (88% of the total), the implantation of a definitive neurostimulator was successful. In almost all patients in both the SBRS and the other groups, the implantation of a definitive neurostimulator was successful. CONCLUSIONS: In our opinion, SCS could be considered as a valid alternative treatment not only in selected patients affected by FBSS but also in selected patients affected by SBRS, in whom back surgery under general anesthesia may be challenging and overcome the potential benefit of the surgery itself. SBRS could be considered a new disease entity to be managed through SCS.


Assuntos
Dor Lombar/terapia , Estimulação da Medula Espinal/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome Pós-Laminectomia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos
7.
Medicine (Baltimore) ; 98(50): e18233, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852086

RESUMO

Percutaneous epidural neuroplasty (PEN) is an effective interventional treatment for radicular pain. However, in some cases, contrast runoff to the spinal nerve root does not occur. We investigated whether contrast runoff to the spinal nerve root affects the success rate of PEN and whether additional transforaminal epidural blocks for intentional contrast runoff affect the success rate of PEN in cases in which contrast runoff is absent.This study was registered at ClinicalTrials.gov (Identifier: NCT03867630) in March 2019. We reviewed the medical records of 112 patients who underwent PEN with a wire-type catheter from May 2016 to August 2018. Patients were divided in 3 groups (Runoff group, Non-runoff group, Transforaminal group).Patients with low back pain and leg radicular pain who did not respond to lumbar epidural steroid injectionsPEN was performed in 112 patients with a wire-type catheter in target segment. We compared the success rate of PEN betweenThe success rate was significantly different between the Runoff group and the Non-runoff group (P < .0007) and between the Non-runoff group and the Transforaminal group (P = .0047), but not between the Runoff group and the Transforaminal group (P = .57).Contrast runoff influenced the success rate of PEN. In cases without contrast runoff, additional transforaminal epidural blocks for intentional contrast runoff increased the success rate of PEN with a wire-type catheter.


Assuntos
Anestesia Epidural/instrumentação , Cateteres , Dor Lombar/terapia , Procedimentos Neurocirúrgicos/métodos , Manejo da Dor/métodos , Raízes Nervosas Espinhais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fluoroscopia , Seguimentos , Humanos , Injeções Epidurais/métodos , Dor Lombar/diagnóstico , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Chiropr Man Therap ; 27: 68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31857892

RESUMO

Background: Recent clinical practice guidelines for the management of non-specific low back pain (LBP) recommend using stratified care approaches. To date, no study has assessed barriers and facilitators for health professionals in using stratified care approaches for managing non-specific LBP in the Canadian primary care setting. This study aimed to identify and contrast barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors. Methods: Individual telephone interviews, underpinned by the Theoretical Domains Framework (TDF), explored beliefs and attitudes about, and identified barriers and facilitators to the use of stratified care approaches for managing non-specific LBP in a purposive sample of 13 chiropractors and 14 physiotherapists between September 2015 and June 2016. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using directed content analysis. Results: Three and seven TDF domains were identified as likely relevant for physiotherapists and chiropractors, respectively. Shared key beliefs (and relevant domains of the TDF) for both physiotherapists and chiropractors included: lack of time, cost, and expertise (Environmental Context and Resources); and consulting more experienced colleagues and chronic patients with important psychological overlay (Social Influences). Unique key domains were identified among physiotherapists: incompatibility with achieving other objectives (Goals), and chiropractors: confidence in using stratified care approaches (Beliefs about Capabilities); intention to use stratified care approaches (Intentions); awareness and agreement with stratified care approaches (Knowledge); assessment of readiness for change and intentional planning behaviour (Behavioural Regulation); and improving the management of non-specific LBP patients and the uptake of evidence-based practice (Beliefs about Consequences). Conclusions: Several shared and unique barriers and facilitators to using the stratified care approaches for non-specific LBP among Canadian physiotherapists and chiropractors were identified. Findings may help inform the design of tailored theory-based knowledge translation interventions to increase the uptake of stratified care approaches in clinical practice.


Assuntos
Quiroprática , Pessoal de Saúde/psicologia , Dor Lombar/terapia , Fisioterapeutas , Adulto , Atitude do Pessoal de Saúde , Canadá , Prática Clínica Baseada em Evidências , Humanos , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Fisioterapeutas/psicologia , Pesquisa Qualitativa
9.
Rev Lat Am Enfermagem ; 27: e3172, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596408

RESUMO

OBJECTIVE: to relate nonspecific low back pain within the nursing work context with their workloads, attrition processes and the risks of illness. METHOD: a cross-sectional study with 301 workers from a general hospital in the south of the country. The Nordic Musculoskeletal Questionnaire and the Work Context Assessment Scale composed of three dimensions were used: working conditions, work organization and socio-professional relations. The association of variables with low back pain was tested using bivariate and multivariate analyzes. The measure of association used was the Odds Ratio and its respective intervals with 95% confidence. The data collected were discussed under the theoretical framework of the work process within the marxist conception and the theory of social determination of the health-disease process. RESULTS: there was a statistically significant association between the dimensions of work organization and working conditions with low back pain and they obtained a critical classification meaning moderate risks to the professional illness. CONCLUSION: the study allowed a better understanding of the nursing work process and its relation with nonspecific low back pain and signaled that changes in the organization and working conditions should occur in order to reduce the risks of nursing workers' illness.


Assuntos
Dor Lombar/terapia , Processo de Enfermagem/organização & administração , Equipe de Enfermagem/organização & administração , Enfermagem/normas , Doenças Profissionais/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Dor Lombar/classificação , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Inquéritos e Questionários , Carga de Trabalho , Local de Trabalho , Adulto Jovem
10.
Clin Interv Aging ; 14: 1729-1740, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631992

RESUMO

Purpose: To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP). Patients and methods: A total of forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment. Results: It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05). Conclusion: The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly. ClinicalTrialsgov Identifier: NCT03898089.


Assuntos
Terapia por Exercício/métodos , Dor Lombar/terapia , Força Muscular/fisiologia , Manipulações Musculoesqueléticas/métodos , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Medição da Dor/métodos , Qualidade de Vida , Método Simples-Cego , Resultado do Tratamento
11.
Tidsskr Nor Laegeforen ; 139(13)2019 Sep 24.
Artigo em Norueguês | MEDLINE | ID: mdl-31556521

RESUMO

BACKGROUND: Low back pain is considered to be the most common single cause of sickness absence. In 2010, Sørlandet Hospital Arendal established an interdisciplinary treatment programme through the Faster Return-to-Work scheme, based on the relevant guidelines for patients with low back pain. In this study we present our experiences from six years of the treatment programme. MATERIAL AND METHOD: Patients who were referred to Sørlandet Hospital in Arendal in the period 2011-16 due to long-term symptoms of low back pain were offered interdisciplinary treatment. This included a one-to-one consultation with a doctor, four weeks of group-based low back school, and physiotherapist-led exercise as well as eight weeks of either physiotherapist-led exercise or home exercise. The degree of sick leave and functional level using scores on the Roland-Morris Disability Questionnaire (RMDQ) were reported at the outset and after 4 and 12 weeks. RESULTS: A total of 43 patients in employment completed the treatment programme. The average age was 41.9 years and 52 % were women. Altogether 57 % were on certified sick leave at the outset and the remainder were assessed as being at high risk of going on sick leave. A total of 7.5 % were placed on sick leave during the observation period, while 28.5 % of those on sick leave were declared completely fit. Altogether 52.7 % of the patients had a clinically significant reduction in RMDQ scores (> 3.5 points). INTERPRETATION: The interdisciplinary treatment programme appears to improve function and reduce sickness absent in patients with long-term low back pain. This study has a short follow-up time and no control group; the observations must therefore be interpreted with caution.


Assuntos
Dor Lombar/terapia , Manejo da Dor/métodos , Equipe de Assistência ao Paciente , Adulto , Avaliação da Deficiência , Terapia por Exercício , Feminino , Hospitais Comunitários , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Educação de Pacientes como Assunto , Modalidades de Fisioterapia , Avaliação de Programas e Projetos de Saúde , Recuperação de Função Fisiológica , Encaminhamento e Consulta , Retorno ao Trabalho , Licença Médica , Inquéritos e Questionários , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(37): e17092, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517832

RESUMO

BACKGROUND: Low back pain (LBP) is a major health problem around the world. Two previous meta-analyses showed that the spa therapy has a positive effect on reducing pain among patients with LBP based on studies published before 2006 and studies published between 2006 and 2013. In recent years, more studies reported the effect of spa therapy on treating chronic low back pain (CLBP). Our study aimed to update the meta-analysis of randomized controlled trials (RCTs) about the effect of spa therapy on treating CLBP and to examine the effect of spa therapy based on different interventions. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched until May 2018 to identify RCTs about spa therapy among patients with CLBP. Summary effect estimates were calculated by using a random-effects model. The quality of each eligible study was evaluated by Jadad checklist. RESULTS: Twelve studies met the inclusion criteria for the systematic review and were included in meta-analysis. There was a significant decrease in pain based on visual analogue scale (VAS) (mean difference [MD] 16.07, 95% confidence interval [CI] [9.57, 22.57], P < .00001, I = 88%, n = 966), and lumbar spine function in Oswestry disability index (ODI) (MD 7.12, 95% CI [3.77, 10.47], P < .00001, I = 87%, n = 468) comparing spa therapy group to control group. Methodological assessment for included studies showed that the study's quality is associated with lacking blinding. CONCLUSION: This updated meta-analysis confirmed that spa therapy can benefit pain reliving and improve lumbar spine function among patients with CLBP. Physiotherapy of subgroup analysis indicated that it can improve lumbar spine function. However, these conclusions should be treated with caution due to limited studies. More high-quality RCTs with double-blind design, larger sample size, and longer follow-up should be employed to improve the validity of study results.


Assuntos
Banhos/normas , Dor Lombar/terapia , Banhos/métodos , Dor Crônica/terapia , Humanos , Medição da Dor/métodos
13.
Medicine (Baltimore) ; 98(37): e17099, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517838

RESUMO

BACKGROUND: This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP). METHODS: Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model. RESULTS: The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = -1.27, 95%CI -1.50 to -1.04, P < .00001, I = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = -1.70, 95% CI -2.63 to -0.76, P = .0004, I = 89%); personal care (WMD = -1.93, 95% CI -2.86 to -1.00, P < .0001, I = 90%); lifting (WMD = -1.69, 95% CI -2.22 to -1.15, P < .0001, I = 66%); walking (WMD = -2.05, 95% CI -3.05 to -1.06, P < .0001, I = 88%); standing (WMD = -1.70, 95% CI -2.51 to -0.89, P < .0001, I = 84%); sleeping (WMD = -2.98, 95% CI -3.73 to -2.22, P < .00001, I = 80%); social life (WMD = -2.06, 95% CI -2.77 to -1.35, P < 0.00001, I = 80%) and traveling (WMD = -2.20, 95% CI -3.21 to -1.19, P < .0001, I = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59-8.86, P < .00001, I = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92-4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = -2.19, 95% CI -2.56 to -1.82, P < .00001). CONCLUSION: We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.


Assuntos
Dor Lombar/terapia , Manejo da Dor/normas , Tai Ji/normas , Humanos , Manejo da Dor/métodos , Modalidades de Fisioterapia/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Tai Ji/métodos
14.
Pain Res Manag ; 2019: 8957847, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31511784

RESUMO

Chronic nonspecific low back pain (CNLBP) is defined as pain or discomfort originating from the waist, which lasts for at least 12 weeks, but no radiculopathy or specific spinal diseases. CNLBP is a complicated medical problem and places a huge burden on healthcare systems. Clinical manifestation of CNLBP includes discogenic LBP, zygapophyseal joint pain, sacroiliac joint pain, and lumbar muscle strain. Further evaluation should be completed to confirm the diagnosis including auxiliary examination, functional assessment, and clinical assessment. The principle of the management is to relieve pain, restore function, and avoid recurrence. Treatment includes conservative treatment, minimally invasive treatment, and rehabilitation. Pharmacologic therapy is the first-line treatment of nonspecific LBP, and it is most widely used in clinical practice. Interventional therapy should be considered only after failure of medication and physical therapy. Multidisciplinary rehabilitation can improve physical function and alleviate short-term and long-term pain. The emphasis should be put on the prevention of NLBP and reducing relevant risk factors.


Assuntos
Dor Lombar/diagnóstico , Dor Lombar/terapia , Grupo com Ancestrais do Continente Asiático , Dor Crônica/diagnóstico , Dor Crônica/terapia , Consenso , Humanos
15.
Artigo em Russo | MEDLINE | ID: mdl-31513164

RESUMO

BACKGROUND: Interstitial electrostimulation (IES) is used to treat spinal pain syndromes. The phenomena occurring in tissue around the electrode that is connected to a vertebra remain unknown. AIM: To reveal the mechanisms of action of IES on inflammatory and dystrophic phenomena and blood flow in osseous and paravertebral tissues in low back pain syndrome. METHODS: Examinations were made in 64 patients with back pain of vertebral genesis in an exacerbation or incomplete remission with intervertebral disc protrusions. Two homogeneous groups of patients treated with different techniques of electrotherapy were identified. A study group was treated with IES, in which the active electrode as a sterile injection needle was brought into the focus of pathology in contact with the diseased vertebra. A control group received a cutaneous procedure with a 50 Hz current with the same physical parameters. Blood flow in the bone and the adjacent tissues and the intensity of pain syndrome were studied. That in the vertebrae was investigated using needle-rheography and polarography. RESULTS: The intensity of pain depends on circulatory disturbances affecting the vertebral tissues, where a focus of inflammation is formed with signs of free radicals, acidosis, and edema. IES could relieve pain in 90.5% of patients. At the same time, blood circulation in the vertebral tissues considerably improved. Cutaneous electrostimulation was not found to have a substantial effect. The result of the therapeutic effect can be explained by electrochemical phenomena in the plasma from the vessels in the focus of inflammation and by electrophysical processes on the cell membranes of the tissue around its anode introduced. CONCLUSION: IES is a pathogenetic treatment. In this case, the active anode electrode must be inserted into the focus of pathology, resulting in a contact with the diseased vertebra.


Assuntos
Terapia por Estimulação Elétrica/métodos , Dor Lombar/terapia , Humanos , Coluna Vertebral , Resultado do Tratamento
16.
J Rehabil Med ; 51(10): 734-740, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31544952

RESUMO

OBJECTIVE: To compare the efficacy of kinesio taping on chronic non-specific low back pain with that of other general physical therapies. METHODS: Relevant studies published up to 31 July 2018 were searched in electronic databases (PubMed, Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), Cochrane Library, Wanfang Data, Vip Data and China National Knowledge Infrastructure). The quality of included studies was assessed using a risk of bias assessment tool, as recommended by the Cochrane Collaboration. Data from visual analogue scales and Oswestry Disability Index were extracted as selected outcome indicators. Tests of heterogeneity were performed. Weight-ed mean difference (WMD) data with its 95% confidence intervals (95% CI) were used as a measure of effect sizes, in order to pool the results from each included study using either a fixed or random effects model (where appropriate and possible). RESULTS: Eight studies fulfilled the inclusion and exclusion criteria. The quality of included studies was moderate. Patients with chronic non-specific low back pain in the kinesio taping group achieved better pain relief (WMD = -1.22; 95% CI -1.49 to -0.96, I2 = 91%, p < 0.00001) and activities of daily living (WMD = -7.11; 95% CI -8.70 to -5.51, I2 = 77%, p < 0.0001) than those in the control group. CONCLUSION: Kinesio taping may be a new, simple and convenient choice for intervention in low back pain. In the future, we can measure the efficacy about kinesio taping via clinical application in order to prove the possibility of treatment for low back pain.


Assuntos
Fita Atlética , Dor Lombar/terapia , Modalidades de Fisioterapia , Humanos
17.
Med. clín (Ed. impr.) ; 153(6): 250-255, sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184032

RESUMO

Las enfermedades reumáticas de afectación axial que cursan con dolor cervical y lumbar son muy prevalentes y conllevan un importante consumo de recursos sanitarios. La acupuntura es un procedimiento médico avalado por la Organización Mundial de la Salud con un amplio abanico de indicaciones. Nuestro objetivo fue revisar la evidencia sobre la eficacia de la acupuntura en estas enfermedades. Se realizó búsqueda sistemática: MEDLINE, CENTRAL y EMBASE (mayo de 2017): 535 citas, incluimos 4 revisiones globales (45 revisiones sistemáticas) y 3 revisiones sistemáticas (70 ensayos clínicos).La acupuntura mejora el dolor cervical y la funcionalidad de forma inmediata y a corto plazo. También es eficaz en lumbalgia aguda y crónica como primera línea terapéutica, comparada con placebo, y como coadyuvante de otros tratamientos convencionales. Es una intervención segura. Los resultados no son concluyentes en radiculopatías (cervicales y lumbares), estenosis canal lumbar y espondilitis anquilosante. Faltan estudios bien diseñados con evaluación a medio y largo plazo


Rheumatic diseases involving the spine, mainly cervical and lumbar spine, are highly prevalent, and consume considerable health resources. Acupuncture is a medical procedure endorsed by the WHO, with a wide spectrum of medical applications. The aim of this study was to review the evidence on acupuncture efficacy in these diseases. A literature search was performed in MEDLINE, CENTRAL and EMBASE (May 2017): 535 citations. We included four global reviews(45 systematic reviews) and three Systematic Reviews(70 clinical trials). Acupuncture improved cervical pain and functionality both immediately and in the short term. It also proved effective in the treatment of acute and chronic low back pain as the first therapeutic line, compared with placebo, and as an adjunct to other conventional treatments. Acupuncture is a safe intervention. However, acupuncture efficacy in radiculopathies (cervical, lumbar), lumbar spinal stenosis and ankylosing spondylitis is still inconclusive. Well-designed studies with medium and long-term evaluation are required


Assuntos
Humanos , Terapia por Acupuntura/tendências , Acupuntura/instrumentação , Doenças Reumáticas/terapia , Doenças da Coluna Vertebral/terapia , Coluna Vertebral/patologia , Dor Lombar/etiologia , Dor Lombar/terapia , Qualidade de Vida
18.
J Athl Train ; 54(7): 772-779, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31386578

RESUMO

CONTEXT: Low back pain (LBP) remains a societal burden due to consistently high rates of recurrence and chronicity. Recent evidence suggested that a provider's treatment orientation influences patient beliefs, the clinical approach, and subsequently, rehabilitation outcomes. OBJECTIVE: To characterize American athletic trainer (AT) and Canadian athletic therapist (C-AT) treatment orientations toward LBP. DESIGN: Cross-sectional study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: A total of 273 ATs (response rate = 13.3%) and 382 C-ATs (response rate = 15.3%). MAIN OUTCOME MEASURE(S): Participants completed demographic questions and the Pain Attitudes and Beliefs Scale (PABS) for ATs/C-ATs. The PABS measures the biomedical and biopsychosocial treatment orientation of health care providers and is scored on a 6-point Likert scale. Descriptive statistics characterized the participants; t tests and 1-way analyses of variance identified differences between group means; and Spearman correlations assessed relationships between the biomedical and biopsychosocial scores and age, number of LBP patients per year, and years of experience. RESULTS: Athletic trainers treating 9 to 15 LBP patients per year had higher biomedical scores (35.0 ± 5.7) than ATs treating 16 to 34 (31.9 ± 5.5, P = .039) or >34 (31.7 ± 8.6, P = .018) LBP patients per year. The C-ATs treating 16 to 34 (31.8 ± 6.3, P = .038) and >34 (31.0 ± 6.7, P < .001) LBP patients per year had lower biomedical scores than those treating ≤8 LBP patients per year (34.8 ± 5.9). The C-ATs with ≤5 years of experience had higher biomedical scores than those with 10 to 15 (31.0 ± 6.7, P = .011) and 16 to 24 (29.8 ± 7.5, P < .001) years of experience. Canadian athletic therapists treating the general public had higher (31.7 ± 4.0) biopsychosocial scores than ATs treating athletes (31.3 ± 3.5, P = .006). The C-ATs ≤35.6 years of age had higher biomedical scores (33.1 ± 5.9) than those >35.6 years of age (30.5 ± 7.0, P < .001). CONCLUSIONS: Athletic trainers and C-ATs who treated more LBP patients per year were more likely to score low on a biomedical treatment orientation subscale. Because this orientation has predicted poor outcomes in other health care providers, further research is needed to determine the effects of ATs' and C-ATs' biomedical orientations on rehabilitation outcomes.


Assuntos
Dor Lombar , Fisioterapeutas , Adulto , Atitude , Canadá , Estudos Transversais , Feminino , Humanos , Dor Lombar/terapia , Masculino , Inquéritos e Questionários
19.
Zhongguo Zhen Jiu ; 39(8): 908-12, 2019 Aug 12.
Artigo em Chinês | MEDLINE | ID: mdl-31397141

RESUMO

OBJECTIVE: To systematically review the current status of application of acupuncture in low back pain guidelines. METHODS: The computer retrieval was conducted in PubMed, Cochrane Library, EMbase, China Journal Full Text Database (CNKI), China Biomedical Literature Database (CBM), VIP, Wanfang, guidelines databases, and the official websites of WHO and academic organizations (American Pain Society, American College of Physicians, etc.). After screening, the basic information and acupuncture-related issues in the guidelines that met the inclusion criteria were extracted and compared by using Excel software. RESULTS: A total of 35 low back pain guidelines were included. ① One guideline was published before 2000, 16 guidelines were published from 2000 to 2010, and 18 guidelines were published from 2011 to 2017; 17 guidelines were published by the United States, 4 by Canada and China, 2 by New Zealand, the United Kingdom, and Europe, and 1 by Netherlands, Philippines, Denmark and Italy. ② Twenty-three guidelines were evidence-based guidelines, which was developed mainly by system review, meta-analysis and expert consultation, involving diagnosis, treatment, primary care of low back pain. ③ Acupuncture was mentioned in 23 guidelines, of them, 7 guidelines recommended acupuncture, 6 guidelines indicated that acupuncture might be considered under certain conditions such as combined with other therapies or patients were interested in acupuncture, however, 10 guidelines did not recommended acupuncture for low back pain. CONCLUSION: The guidelines of low back pain are mainly developed by Europe countries and the United States, and the majority is published in the last 20 years. Among them, 20% of the guidelines have recommend acupuncture for low back pain.


Assuntos
Terapia por Acupuntura , Dor Lombar/terapia , China , Europa (Continente) , Humanos , Países Baixos , Nova Zelândia , Guias de Prática Clínica como Assunto , Reino Unido
20.
Medicina (Kaunas) ; 55(8)2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31409017

RESUMO

Low back pain is an extremely common pathology affecting a great share of the population, in particular, young adults. Many structures can be responsible for pain such as intervertebral discs, facet joints, nerve roots, and sacroiliac joints. This review paper focuses on disc pathology and the percutaneous procedures available to date for its treatment. For each option, we will assess the indications, technical aspects, advantages, and complications, as well as outcomes reported in the literature and new emerging trends in the field.


Assuntos
Disco Intervertebral , Dor Lombar/diagnóstico , Dor Lombar/terapia , Vértebras Lombares , Humanos , Disco Intervertebral/diagnóstico por imagem , Disco Intervertebral/patologia , Dor Lombar/patologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Doenças da Coluna Vertebral/diagnóstico , Tomografia Computadorizada por Raios X
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