Common Chronic Low Back Pain

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Chronic low back pain& psychological comorbidity

Chronic low back pain& psychological comorbidity

Aim:Low back pain is a common disease, and it is observed at least once in 70-85% of the population during their lifetime.Chronic low back pain (CLBP)interferes with the physical ability and mobility of high number of people. This study will determine if there is a relationship between mental disorders including depression, hypochondriasis and anxiety, and the functional status of patients suffering from chronic low back pain.Subjects and methods: The study was performed on a sample of 200 agreed to participate in this cross-sectional study. The patients were divided equally into two separate groups: first group consisted patients with chronic low back pain with clear organic lesion and validated radiologically.The second group consisted of patients with chronic low back pain in which no clinical and radiological confirmation for an organic lesion, or called functional group. Every patient has undergone to the following procedures: A) Medical evaluation including (Neurological evaluation, systemic examination mainly gynecological examination in all female patients and radiological examination mainly Plain x-ray of lumbosacral spine and Magnetic Resonence Imaging(MRI) lumbosacral spine. B) The psychological evaluation used to measure anxiety, depression and hypochondriasis by adopting the MMPI Questionnaire Results: This study sample has included 53% males and 47% females in organic group while 30% males and 70% females in functional group. In Organic group, age and LBPwere found to be significantly associated. Radiation was absent in 9% of patients in organic group and in 60% of patients in functional group. Parathesia present in 85% of organic group, while functional group 20%. 70% of those in organic group and 25% of those in functional group reported severe pain.Depressionwas observed in 15% oforganic group
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The effectiveness of a simplified core stabilization program (TRICCS—Trivandrum Community-based Core Stabilisation) for community-based intervention in chronic non-specific low back pain

The effectiveness of a simplified core stabilization program (TRICCS—Trivandrum Community-based Core Stabilisation) for community-based intervention in chronic non-specific low back pain

Low back pain is a common musculoskeletal problem af- fecting the population both in developing and developed world. It is the major cause of work absenteeism and mus- culoskeletal disability [1]. Chronicity of low back pain leads to significant expenses causing strain on the health care system. Eighty percent of the population is expected to suffer from low back pain at one time or other during their life. In developed countries like the UK, the point prevalence of low back pain is estimated to be close to 50% [2, 3]. In the USA, the point prevalence ranges from 8 to 56% [4]. Various studies of low back pain epidemi- ology done in India give the prevalence of low back pain (LBP) between 6.2 and as high as 92% depending on the population studied [5]. In the majority of people, back pain is self-limiting. However, a significant percentage of these patients develop to have chronicity of their symptoms.
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Imperforate Hymen Presenting as Chronic Low Back Pain

Imperforate Hymen Presenting as Chronic Low Back Pain

infants, IH is an incidental fi nding dur- ing genital examination. In adolescents, it may be detected during evaluations for primary amenorrhea. Common clinical manifestations are a bulging blue-black membrane in the vulva, cy- clic abdominal pain and/or a pelvic mass, and primary amenorrhea with normal secondary sex characteristics. The aim of the present report was to describe an adolescent girl with IH who presented with long-term low back pain.

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The efficacy of neuromuscular taping on various pain parameters among  chronic low back pain population

The efficacy of neuromuscular taping on various pain parameters among chronic low back pain population

lower back .it is bone of the most common reasons people miss work. Low back pain is usually caused when alignment or muscle holding a vertebra in its proper position is strained 24 . According to World Health Organization, Low Back Pain is responsible for a major portion of people staying away from work or visiting a medical practitioner. It is estimated that 70% to 80% of the world’s population has at least one episode of back pain in their life time. This condition may cause a decrease in the quality of life of individuals, as well as deterioration in physical activity. Generally incidents of back pain most commonly occur in between ages 25 and 50 years 25 . In many low income countries especially in Ethiopia lack of knowledge about the effect of physiotherapy services and having an attitude that physiotherapy is giving massage only, results in patients long term disability, dependency and increase in number of handicaps 18 .
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Chronic low back pain: Osteopaths’ attitudes and management

Chronic low back pain: Osteopaths’ attitudes and management

It could be reasoned that CLBP is one of the most common conditions seen by many osteopaths in practice. However there has been limited consideration given to understanding the ways in which osteopaths are managing CLBP and their attitudinal barriers to optimal pain management. Even though there is evidence that poor practitioner knowledge of management and attitudes plays a role in the inadequate management and treatment of pain by physicians and physical therapists it is not known if this is the case for osteopaths. 3,10-12 This

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ROLE OF NIRUHA BASTI GIVEN MORE THAN ONE IN A DAY IN NEUROLOGICAL LOW BACK PAIN

ROLE OF NIRUHA BASTI GIVEN MORE THAN ONE IN A DAY IN NEUROLOGICAL LOW BACK PAIN

Background: Low back pain is widely prevalent these days due to living habits and hazardous work pattern. It is very common healthy problem. It can be acute or chronic. At present it is mainly treated with analgesic. Alternate treatment include physical therapy, rehabilitation and spinal manipulation by disc surgery remains last option when all other strategies have failed but outcomes are disappointing. [6] There are many causes of acute low back pain at out of them spinal nerves root injury or compression is one of cause. Also stress factor may cause the low back pain. In ayurveda there is no exact clinical entity mentioned in classics as katishool but it comes under many diseases as a symptom. As the pain that means shool which is exclusively due to vitiation of vata dosha. [9] As per ayurved Samhita samprapti of vatvyadhi has been described in two different types as upstambit and nirupstambit vatvyadhi. Basti is practiced widely in Ayurveda community for different vyadhis but niruha basti is given once a day. Only when Bruhatrayee persistently indicating more than one basti in a day to attain samyaka niruha lakshana.
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The Role of Body Weight and Growing in Body Height to Nonspecific Musculoskeletal Pain in a Cohort of Bosnia and Herzegovina Schoolchildren

The Role of Body Weight and Growing in Body Height to Nonspecific Musculoskeletal Pain in a Cohort of Bosnia and Herzegovina Schoolchildren

A musculoskeletal pain (MSP) in children is important public health problem, which is manifested in only occasional limiting movements with pain and usually with little clinical implications [1]. A nonspecific musculoskeletal pain (NSMSP) in childhood includes often a specific, identifiable pathoanatomical basis for symptoms cannot be found, resulting in non-specific diagnoses based on the location of symptoms [2]. Amongst various risk factors, it has been suggested that elevated body mass index (BMI), overweight and obesity might be an independent risk factor for NSMSP [3]. The relationship between BMI and MSP has mainly been investigated in studies on low back pain (LBP) [4-6]. Body height was associated with increased risk of low back pain in both genders [7]. MSP in the lower extremities occurs both in children and in adolescents with ankle and foot problems being more common in children [8]. There is emerging evidence that children, especially adolescents who report persistent musculoskeletal pain, are at increased risk of chronic pain as adults [1,2,5]. The time of adolescence is the transition period from childhood to adulthood and over only a few years, both body and soul will undergo many changes. The most apparent morphological differences are increased height and a change in body composition. It has been proposed that these may impact LBP [8-10].
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TO STUDY THE EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION ON BACK MUSCLE STRENGTH, PAIN AND QUALITY OF LIFE IN SUBJECTS WITH CHRONIC LOW BACK PAIN AN EXPERIMENTAL STUDY

TO STUDY THE EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION ON BACK MUSCLE STRENGTH, PAIN AND QUALITY OF LIFE IN SUBJECTS WITH CHRONIC LOW BACK PAIN AN EXPERIMENTAL STUDY

During past few years, it has been observed that a new class of young sedentary back pain sufferers is emerging who are becoming more frequent visitors of Orthopaedic clinics. They usually are in a profession where prolonged sitting on chairs is essential like computer/visual display unit users, bank clerks, accountants, stock exchange workers, industrial workers, architects, etc. Prolonged continuous sitting in an inactive posture is a common feature among computer/visual display unit users as technology and its use is becoming more and more common. 5
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Study protocol: Transition from localized low back pain to chronic widespread pain in general practice: Identification of risk factors, preventive factors and key elements for treatment – A cohort study

Study protocol: Transition from localized low back pain to chronic widespread pain in general practice: Identification of risk factors, preventive factors and key elements for treatment – A cohort study

The association of CWP and several physical and psy- chological factors are well-documented. Studies show high prevalence of comorbidities [5] (most common are anxiety and somatization disorders). CWP patients are more often of older age, female, less educated and have decreased health related quality of life [6]. They show restricted functional ability [7] and frequently receive a disability pension [8]. In addition, there is a high social and economic burden of chronic pain, especially CWP [9]. These studies are population-based cross-sectional and cannot determine the temporal relationship between predictors and the development of CWP (generalization of pain). There are few prospective studies that explore predictors for the onset of CWP. Gupta and colleagues performed a population-based prospective study (EPI- FUND-study) [10]. They identified the following disor- ders to be associated with CWP: psychological distress (in this case anxiety, depression, somatization disorders) [10], health related quality of life [11], physical inactivity [12], and sleep disorders [13].
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Transdermal Fentanyl for Chronic Low Back Pain

Transdermal Fentanyl for Chronic Low Back Pain

Purpose: Chronic low back pain is a common clinical problem. As medication, non-steroidal anti-inflammatory drugs are generally used; however, they are some- times non-effective. Recently, opioids have been used for the treatment of chronic low back pain, and since 2010, transdermal fentanyl has been used to treat chronic non-cancer pain in Japan. The purpose of the current study was to examine the effi- cacy of transdermal fentanyl in the treatment of chronic low back pain. Materials and Methods: This study included patients (n=62) that suffered from chronic low back pain and were non-responsive to non-steroidal anti-inflammatory drugs. Their conditions consisted of non-specific low back pain, multiple back operations, and specific low back pain awaiting surgery. Patients were given transdermal fentanyl for chronic low back pain. Scores of the visual analogue scale and the Oswestry Disability Index, as well as adverse events were evaluated before and after therapy. Results: Overall, visual analogue scale scores and Oswestry Disability Index scores improved significantly after treatment. Transdermal fentanyl (12.5 to 50 μg/h) was effective in reducing low back pain in 45 of 62 patients; however, it was not effec- tive in 17 patients. Patients who experienced the most improvement were those with specific low back pain awaiting surgery. Adverse events were seen in 40% of patients (constipation, 29%; nausea, 24%; itching, 24%). Conclusion: Transdermal fentanyl significantly improved visual analog scale scores and Oswestry Disability Index scores in 73% of patients, especially those with specific low back pain await- ing surgery; however, it did not decrease pain in 27% of patients, including patients with non-specific low back pain or multiple back operations.
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Health utilities for chronic low back pain

Health utilities for chronic low back pain

The present study shows that on average chronic LBP patients chose a 7% shorter life expectancy and healthy participants chose a 10% shorter life expectancy to avoid chronic LBP, but almost 1 in 10 participants were not willing to trade any life years. Since LBP is one of the most common diseases in the population and has high preventive potential, these HU can give decision makers in preventive health promotion and health care valuable insight to how patients and healthy individuals perceive chronic LBP. Furthermore, the results indicate a certain stability of HU due to the comparability of HU ratings across patients and healthy participants, the measure- ment consistency and association between VAS and HU, and the lack of association between demographic vari- ables and HU. The results point towards an applicability of HU for assessing illness severity of LBP specifically and the applicability of HU for diseases that are mainly characterized through pain in general. Future studies looking at pain-characterised diseases should include explicit descriptions of pain intensities in their disease scenarios and independently assess HU for these differ- ent pain intensities ideally in a sample that is representa- tive of the population of interest.
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Prediction of clinical outcomes in individuals with chronic low back pain: a protocol for a systematic review with meta-analysis

Prediction of clinical outcomes in individuals with chronic low back pain: a protocol for a systematic review with meta-analysis

Low back pain (LBP) is one of the most prevalent types of chronic pain in clinical practice [1]. Researchers esti- mate that low back pain affects 4–33% of the population at any given point, and will affect 60–80% of the popula- tion at some point during life, and this prevalence in- creases with age [2–4]. After an acute low back pain episode, the majority (about 90%) recovers in a few months [5, 6], although recurrences are common (vary- ing between 25 to 50% in a year) [7]. Furthermore, LBP recurrences are the main occurrence responsible for seeking health care, sick leave and other work-related problems and activity limitations, which lead to a major impact on financial and human resources [7]. Definitions of onset or conclusion of an acute or subacute low back pain episode and what is considered recovery are still unclear [8].
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Validity and reliability of arabic version of low back pain rating scale in patient with low back pain

Validity and reliability of arabic version of low back pain rating scale in patient with low back pain

Low back pain (LBP) is a very common health problem worldwide and a major cause of disability affecting performance at work and general well-being. LBP can be acute, sub-acute, or chronic. Though several risk factors have been identified (including occupational posture, depressive moods, obesity, body height and age). The causes of the onset of low back pain remain obscure and diagnosis difficult to make. Back pain is not a disease but a constellation of symptoms. In most cases, the origins remain unknown (Atlas and Deyo, 2001). Low back pain prevents normal activity and affects the capacity to work. For society, it means lost work days; for the individual, it means both lower income and a reduced quality of life as a result of pain and immobility (Burström et al, 2003). Since low back pain is common and difficult to treat effectively, it is a condition that leads to long- term absence and, consequently, a high economic burden to society.(Maetzel and Li,2002).Several studies have been performed in Europe to evaluate the social and economic impact of LBP. In the United Kingdom, LBP was identified as the most common cause of disability in young adults, with more than100 million work days lost per year (Croft et al., 1993).
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The prevalence and clinical characteristics of nonradiographic axial spondyloarthritis among patients with inflammatory back pain in rheumatology practices: a multinational, multicenter study

The prevalence and clinical characteristics of nonradiographic axial spondyloarthritis among patients with inflammatory back pain in rheumatology practices: a multinational, multicenter study

The authors also acknowledge the various institutional review boards and ethics committees of the participating institutions: Shanghai Changhai Hospital Ethics Committee (China), Chung Shan Medical Hospital (Taiwan), Kaohsiung Medical University (Taiwan), Chung-Ho Memorial Hospital (Taiwan), Medical Research & Ethics Committee (Malaysia), Bangabandhu Sheikh Mujib Medical University (Bangladesh), Christian Medical College (India), Nizam ’ s Institute of Medical Sciences (India), Institutional Ethics Committee of Human Research at Medical College (India), KIMS Foundation and Research Center (India), Bnai Zion Medical Center (Israel), Meir Medical Center (Israel), Dokuz Eylul University (Turkey), Warsaw University of Medicine (Poland), University of Szeged Albert Szent-Gyorgyi Clinical Center (Hungary), Table 6 Clinical outcomes and patient-reported outcome measures for patients with nonradiographic axial spondyloarthritis, ankylosing spondylitis, and other inflammatory back pain
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Sling Suspension Therapy Utilization in Musculoskeletal Rehabilitation

Sling Suspension Therapy Utilization in Musculoskeletal Rehabilitation

There are various factors that can be utilized during SET for allowing its maximum effects in both therapeutics and diagnostics. These include ropes level, vibration, and positions. In particular, there are three main types of supporting ropes including single, double, and pulley, which can be adjusted relative to the case. For example, multi-point suspensions at different angels beget a better therapeutic efficiency for various individuals. Fur- thermore, multi-points suspension stimulates the target muscles without pain because the body weight is loaded by the bungees assuring safety [31]. This offers many advantageous. In contrast, single-point suspension offers a low degree of safety during exercise as well as weight bearing (Figure 2). For instance, Kanehisa and cowork- ers reported that the muscles are activated well in the LBP patient upon usage of SET relative to the ground- based push-ups exercise via engaging into the multi-suspension SET. Specifically, the activation in the upper limb and anterior trunk muscles are significantly improved compared to the ground-based push-up exercise [19]. It is noteworthy that, elasticity of the used cords during SET can be used to assist or resist the muscles move- ments, enabling their facile restoring. Those are subsequently being adapted according to the current muscles strength to shorten the treatment time. This is ascribed to the fact that, the patient’s body is fully bearded by the ropes resulting in reducing their stress during training.
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Supervised and non supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

Supervised and non supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

This is the first study evaluation the effectiveness of NW in back pain patients and we have therefore learned important lessons in relation to this intervention. First and foremost, it was not easy to recruit participants and consequently the inclusion period was extended several times. Since NW is a novel and experimental treatment for back pain, patients may not have considered it to be a “ real ” or “ serious ” treatment for their chronic problem and highly motivated recruitment personnel is essential if future trials involving this intervention are underta- ken. Second, there may have been a certain stigmatism around NW which in the public is often associated with elderly frail persons. Our target population was in their middle to late forties and may therefore have been reluctant to engage in such an activity. Interestingly and quite contrary to popular beliefs in Denmark, NW is also performed by young, highly trained and skilled indi- viduals who compete at an international level and thus this intervention may be perceived differently in other countries [1]. Third, it is obvious based on the acceler- ometer data that the trained instructors were not able to motivate the participants in the supervised NW group to elevate their general physical activity level. In fact, some of the participants were not even able to comply with the very reasonable predetermined intensity
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RCCSS(C) Research Funding Awards

RCCSS(C) Research Funding Awards

Cechi et al (2012) found that spinal manipulation showed the best improvement when compared with in- dividual physiotherapy. Spinal manipulation appears to have produced the best results in both outcomes, pain re- duction and improved function, however this has not been able to promote active self-treatment. This implies that spinal manipulation therapy depends on the availability of a specialist in spinal manipulation.

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Effects of obesity and chronic low back pain on gait

Effects of obesity and chronic low back pain on gait

Background: Obesity is often associated with low back pain (LBP). Despite empirical evidence that LBP induces gait abnormalities, there is a lack of quantitative analysis of the combined effect of obesity and LBP on gait. The aim of our study was to quantify the gait pattern of obese subjects with and without LBP and normal-mass controls by using Gait Analysis (GA), in order to investigate the cumulative effects of obesity and LBP on gait. Methods: Eight obese females with chronic LBP (OLG; age: 40.5 ± 10.1 years; BMI: 42.39 ± 5.47 Kg/m 2 ), 10 obese females (OG; age: 33.6 ± 5.2 years; BMI: 39.26 ± 2.39 Kg/m 2 ) and 10 healthy female subjects (CG; age: 33.4 ± 9.6 years; BMI: 22.8 ± 3.2 Kg/m 2 ), were enrolled in this study and assessed with video recording and GA.
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Chronic low back pain patient groups in primary care – A cross sectional cluster analysis

Chronic low back pain patient groups in primary care – A cross sectional cluster analysis

During a 5-month period, fifty-eight general practitioners (evenly distributed in the northern region of Hessen in Germany) consecutively enrolled all eligible patients consulting for CLBP as a primary or secondary consulting reason (inclusion criteria). The symptom “chronic low back pain” was defined as back pain below the costal margin and above the inferior gluteal folds (with or without pain radiation), which had started at least three months prior and continued during most days (i.e., more than 50%) in the last three months. Patients under 18 years, pregnant women, and persons with an insufficient understanding of the German language or severe cognitive impairments (e.g., dementia) were excluded from the study.
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A cross sectional study between the prevalence of chronic pain and academic pressure in adolescents in China (Shanghai)

A cross sectional study between the prevalence of chronic pain and academic pressure in adolescents in China (Shanghai)

Chronic headache is not a rare condition in adolescents [22]. A study in German showed that over 80 % of ado- lescents aged 13–18 years had self-reported headache symptoms in the last 6 months [22] (defined according to the German version of the International Classification of Headache Disorders (2nd Edition)). Worldwide, 54.4 % of the adolescent population suffers from head- aches [23]. This study showed that 30.3 % of Chinese ad- olescents experienced headaches more than once per week in the last 3 months. Moreover, the prevalence of chronic headache was closely related to the average daily study time, extracurricular learning tasks, and stress re- ceived from parents, classmates, and teachers. The rea- son may be that heavy academic pressure induces an increase in risk factors for headaches (elevated levels of mental stress, lack of sleep, and less exercise) [24] and changes in adolescents’ living habits (smoking, alcohol and coffee consumption), perhaps promoting the preva- lence of chronic headache nonspecifically [25].
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