Salmon calcitonin (SCT) is an anti-resorptive agent that has been available for over 30 years. SCT is approved for the treat- ment of post-menopausal osteoporosis, bone associated pain, and metabolic bone disease. SCT is commercially available as an injectable and as a nasal spray. A new oral formulation has been recently developed, and data from the first clinical trials indicate a potential utility not only in osteoporosis but also in osteoarthritis. Recent interest in SCT in the management of OA is due to its potential chondro-protective capabilities and analgesic effects. While the kinetics of calcitonin-induced pain relief have not been conclusively shown, potential mechanisms include an endorphin-mediated effect through the elevation of endogenous B-endorphin levels, centrally mediated pain relief via central nervous system binding sites, and stimulation of descending spinal serotonergic pathways. 33
We searched electronic databases PubMed and EMBASE (to May 2016) using controlled vocabulary and keyword variations of the concepts: emergency department, lowbackpain and prevalence (see Additional file 1 and Add- itional file 2). We conducted citation searches of seminal studies [9, 10, 12–15]. For studies with greater than 500 citations, we searched within citations for “emergency de- partment” using Google Scholar. We reviewed reference lists of included studies to identify other potentially rele- vant studies. Additionally, our literature search incorpo- rated all relevant literature that was identified in a broad scoping review mapping published research studies about backpain in the emergency department . We searched for relevant subsequent publications for any abstracts identified.
Lowbackpain 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 . Chronicity of lowbackpain leads to significant expenses causing strain on the health care system. Eighty percent of the population is expected to suffer from lowbackpain at one time or other during their life. In developed countries like the UK, the point prevalence of lowbackpain is estimated to be close to 50% [2, 3]. In the USA, the point prevalence ranges from 8 to 56% . Various studies of lowbackpain epidemi- ology done in India give the prevalence of lowbackpain (LBP) between 6.2 and as high as 92% depending on the population studied . In the majority of people, backpain is self-limiting. However, a significant percentage of these patients develop to have chronicity of their symptoms.
Members of Group Health Cooperative in Seattle and Kai- ser Permanente Northern California in Oakland whose visits to healthcare providers resulted in diagnoses con- sistent with non-specific lowbackpain will be identified from the health plans' automated visit data. Three to 12 months after their visit, potential participants will be mailed a letter that explains the study, describes eligibility requirements, and invites participation. Members inter- ested in participating will sign and return a statement indicating their willingness to be contacted by study staff. An interviewer will then phone the members to answer questions and determine eligibility using a computer pro- gram to guide the members through a series of screening questions. If eligible, the study staff guides the patient through the consent process. Once written consent is obtained, an interviewer will contact the potential partic- ipant to administer the baseline questionnaire. If still will- ing to participate, participants will be randomized to one of the four groups. If the participant is randomized to acu- puncture, the interviewer will schedule the first two acu- puncture appointments.
Lowbackpain (LBP) is a common complaint amongst women during pregnancy, having a great impact on their quality of life. Lowbackpain during pregnancy has been known and recognized for many centuries and was described by Hippocrates, Vesalius, Pineau, Hunter, Velpeau and many others. In 1962 Walde was the first who recognized the differences between Pelvic Girdle pain (PGP) and Lumbar pain (LP). Later, Ostgaard et al. set the criteria for the differentiation between these two entities.  It has been estimated that about 50% of pregnant women will suffer from some kind of lowbackpain at some point during their pregnancies or during the postpartum period. [2-4] Pregnancy-related lowbackpain seems to be a result of quite a few factors, such as mechanical, hormonal and other. [2, 3, 5-12] PGP and LP are two different patterns of LBP during pregnancy, although, a small group of women suffer from combined pain. PGP is common during pregnancy and postpartum period and approximately four times as prevalent as LP. It is described as deep, stabbing, unilateral or bilateral, recurrent or continuous pain, presenting between the posterior iliac crest and the gluteal fold, possibly radiating to the posterolateral thigh, to the knee and calf, but not to the foot.  PGP is more intense during pregnancy than during postpartum period and may convert the natural discomfort of pregnancy into a pathophysiologic condition, which minimizes physical activity, and causes withdrawal from social interactions14. Pain provocation tests are the best tests available for differentiating PGP from other conditions. The posterior pain provocation test (PPT) is positive, in case of PGP. [2,3,6,15,16] LP during pregnancy is very similar to lumbar pain experienced by women who are not pregnant and it appears as pain over and around the lumbar spine, above the sacrum, making the differentiation between PGP and LP easy. LP may or may not radiate to the foot, in contrast with PGP. Tenderness over paravertebral muscles is a common finding.  LP aggravates at postpartum period and usually exacerbates by certain activities and postures (e.g. prolong
In Siddha system of medicine, “tongue” is well-regarded as one of the most significant diagnostic tool for a wide number of diseases. Since the tongue is a mirror of our body and it is a hypothetical point, the midline fissure (MLF) in tongue may reflect the disorders of midline structures in the body. In ancient Siddha literature by Sage Agasthiyar, the presence of fissure in tongue is described as an indicator of derranged vatha humour. This observational study was conducted among 3 groups of patients to observe and analyse the clinical presentation of patients having mid-line fissure in tongue and thereby to evolve significant diagnostic clue from tongue examination. Group I, included 100 cases with mid-line fissure in tongue and their clinical presentation was observed and documented. Group II consisted of 30 patients with lowback ache [without any major illness] and were observed for the presence of midline fissure. In Group III (control group) 50 general patient population irrespective of their diseases were studied for the presence of midline fissure and associated symptoms. All the results were documented and the strength of association of midline fissure and lowbackpain (LBP) was statistically analyzed by using Odds ratio and were also represented graphically. From this preliminary effort it has been evident of an association between Mid-line fissure & lowback ache condition.
Gary is a full-time shop owner. The role involves prolonged sitting and standing and also involves moving and sorting heavy deliveries. He has a history of lower backpain but 6 weeks ago his symptoms altered fol- lowing an incident at work lifting heavy boxes. Previously he com- plained of a constant, but variable, ache across the lumbar region and buttocks, affecting daily activities. Since the recent injury he reports unre- mitting pain in the lower back (Gary indicates this to be in the L4–L5 region). He also complains that he has a ‘numb bum’ with pins and needles in the right leg.
This was a case control study, conducted in training and rehabilitation centers of Iranian athletic teams in the city of Tehran. 50 athletic patients with lowbackpain (36 males, 14 females, mean age =23.20±12.79 years) and 51 healthy athletes (36 males, 15 females, mean age =24.28± 13.70) from Iranian athletic teams were screened for hyper mobility using the Beighton method. Each participant completed a health history and sport participation questionnaire about demographics, years of athletic participation and history of back disorders and pain. After completing the questionnaire, participants were given numerical scores of 0 to 9 according to the Beighton method (3), one point being awarded for the ability to perform each of the following tests: 1- Passive extension of the little fingers beyond 90º. 2- Passive opposition of the thumbs to the flexor aspects of the forearms. 3- Hyperextension of the elbows beyond 10º. 4- Hyperextension of the knees beyond 10º (these four maneuvers are performed on the right and left sides). 5- Forward flexion of the trunk so that the palms easily touch the floor. A score of 5 or higher meets the Beighton score for hypermobility (5). Subjects were excluded if they had had previous shoulder surgery and any upper extremity or spine abnormality (4). The control
This is compounded by the fact that a nurse repeats these actions multiple times during a day, for days on end. Typically, nurses may find themselves lifting an average of twenty patients daily. This is in addition to moving an average eight patients from their bed to a chair and back. “Patients are sicker and bigger than they’ve been historically,” explains Schaumleffel, making nurses’ jobs more dangerous to their own health. The frequency of manual labour on the job also increases the risk throughout a career. “Back injuries are micro traumas the damage accumulates over time,” she says. The more you work in awkward postures or lift heavy loads, the greater your risk. If a patient is unconscious, nurses will try to turn him every two hours or so to prevent bed sores. Pain is an unpleasant emotional state felt in the mind but identifiable as arising in a part of the body. In other words, it is a subjective sensation. Pain is a defense mechanism designed to make the subject protect an injured part from further damage. Lowbackpain (LBP), perhaps more accurately called lumbago or lumbosacral pain, occurs below the 12th rib and above the gluteal folds. Lowbackpain is a well-recognized cause of morbidity in the industrialized world, where several studies have reported the occurrence of LBP in general population and occupational settings .The complaint of backpain is among the most common medical conditions.
Backpain is one of the most costly conditions for which an economic analysis has been carried out in the UK, according to the NHS Pathfinder project (2014), a finding in line with the situation in other countries. Employers and the work force in general carry a great burden related to lowbackpain and other work-related musculoskeletal disorders (WRMSD, which include back, upper and lower body limb disorders) (Buckley 2015). Only the common cold exceeds backpain as a reason people seek medical health in the UK: almost 7 million GP visits are due to backpain annually (Johnson 2012).
The particular concern identified by this study was that most papers reported their adolescent subjects as suffering lowbackpain, without consideration of the definitional parameters. This constrains the ability to synthesize the literature to identify risk factors, as studies with different pain definitions (in terms of severity, chronicity, and intensity) lack homogeneity, as they are describing different pain situa- tions. 16 Within each of the three broad classifications used in
Demographic details (age, BMI, previous pregnancies, history of mental health issues) were gathered from par- ticipants’ case notes by study personnel. Two survey items collected previous history of lowback and pelvic girdle pain prior to pregnancy, and the use of pain medi- cation prior to their appointment. History of mental health issues were captured from the case notes, on the basis of either, one, the participant having case note re- cords for medical treatment sought through the Lyell McEwin Hospital for mental health issues, or two, if pa- tients reported a history of mental health issues to the midwife during their first antenatal visit (for example, depression, anxiety, bipolar disorder, bulimia etc). Women were then required to answer two questions about previous history of lowback and pelvic girdle pain
1.5) Physical activity during leisure time: association with lowbackpain Whilst activity is advocated during an acute episode of LBP, and has been shown to be associated with less disability and less time off work than rest (Waddell et al, 1997; Van Tulder et al, 2000), its effects on pre-existing dormant LBP are unknown. Physical activity outside of work could either protect against or increase the risk of LBP at work (Abenhaim et al, 2000). Nourbakhsh et al (2001) evaluated the effects of leisure activity on LBP, and the occurrence of symptoms was significantly lower in subjects who exercised regularly. However, sedentary workload and activity was self-reported, and for studying exposure- effect relationships is not valid (Viikari-Juntari et al, 1996). Studies have also reported no association between LBP and leisure activity (Rossignol et al, 1993; Kuaja et al, 1996; Croft et al, 1999). Campello et al (1996) concluded that studies do support the hypothesis that general exercise protects against LBP. Another systematic review has also found that inactivity during leisure-time is associated with a high prevalence of LBP, and related sickness absence among sedentary workers (Hildebrandt et al, 2000). Overall, the use of surveys, lack of prospective follow-up, and absence of standardised definitions for ‘sedentary work’ and ‘leisure activity’ limits the literature. General and sporting activity have also not been regarded as factors that may infer separate levels of risk, these being contained under the term ‘leisure activity’ (Jacob et al, 2004).
I hereby declare that the present dissertation titled “ A study to assess the effectiveness of Guided Imagery Technique in reducing lowbackpain perception and lowbackpain disability among third trimester antenatal mothers .”is the outcome of the original research work undertaken and carried out by me, under the guidance of Mrs. M. Anbarasi, M.Sc.,N, HOD of Obstetrics and Gynecological Nursing, Nehru Nursing College, Vallioor. I also declare that the material of this has not formed in any way, the basis for the award of any degree or diploma in this university or any other universities.
investigated risk factors for LBP in the general popula- tion, and found that people with lower PPT (below the 10th percentile of PPT distribution) were not at higher risk of developing future LBP. Whether or not this result would have been different if suprathreshold measures of pain sensitivity were used is unknown. However, if indeed dynamic QST tests are more clinically relevant measures of pain sensitivity, then we would have expected an associa- tion in the studies reporting these measures in the current review. One explanation could be the low prevalence of pain hypersensitivity in the cohorts investigated. Indeed, one of the three studies 31 in this review did report that only a small
Lowbackpain is very common. It affects 4 out of 5 people at some time during their lives. It is the leading cause of disability for those aged 19 to 45 and is the second most common cause of missed workdays for adults younger than 45 years of age. According to one study, almost 80 percent of people in modern industrial society will experience backpain at some time during their life. Fortunately, in 10 percent of these, it subsides within a month. But in as many as 70 percent of these, the pain Various studies have shown that the incidence of backpain is more in women then in men. Backpain is more common in women who have had several xercise, leading to poor muscle tone and nutritional osteomalacia are contributory factors in these patients. In the present module, 11 colour pictures have been utilized to demonstrate the correct posture to be adopted to
Lower backPain is widely considered as a bio-psycho-social issue (Waddell, 2004). It is known that LBP risk increases with the presence of physical and psychological stressors.  This study displays that the occurrence of LBP increased between 20 to 40 years and more in female in functional group, which matches the result ofKostova and Koleva study.  It has shown that women (53.9%) experience LBP symptoms more than men (46.1%). This result is consistent with other studies findings, which reported that LBP is more likely to be reported by females than males (Dempsey, 1997), the high LBP incidence in women could be explained in the fact that women are always under more stress related to their work and their high responsibilities towards their families. In the present study, LBP and psychological distress are significantly associated.The depression represent 15% in organic group, 35% in Functional group, and anxiety disorders 14% in organic group , 20% in Functional group. These results were higher compared to their healthy people. On the other hand, the level of anxiety and depression is the same in patients with excessive and without excessive pain behavior, especially in females, as stated by Dickens et al. (2002). Moreover, studies has shown that LBP and physiological distress are significantly associated (Bener, 2012; Schneider, 2005; Manchikanti, 2003). Researchers have extensively studied the association between depression and pain unexplained medically, and it was positive between depression and somatoform disorders (Al-Shammari, 1994; Delisa, 2005; Palmer, 2000 and Cassidy, 1998). To illustrate the mechanism of how depression can cause unexplained pain, several hypotheses have been arisen (Al- Shammari, 1994 and Palmer, 2000).
Most individuals will develop lowbackpain at some point in their life, as the lifetime prevalence is between 49 and 90% . It is currently accepted that the manage- ment of lowbackpain should begin in the primary care setting , and over half of visits for lowbackpain are to primary care physicians . Nevertheless, a recent systematic review on the prevalence of lowbackpain in emergency settings  suggests that lowbackpain is a common presenting complaint to this setting (pooled prevalence estimate 4.3%). Results from the same sys- tematic review  indicated that there are a number of gaps in the literature, particularly a lack of clear and de- tailed definitions of lowbackpain. Additionally, the re- view identified a need for studies comparing prevalence results from multiple definitions of lowbackpain and research conducted in Canada .
Lowbackpain (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 lowbackpain remain obscure and diagnosis difficult to make. Backpain is not a disease but a constellation of symptoms. In most cases, the origins remain unknown (Atlas and Deyo, 2001). Lowbackpain 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 lowbackpain 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).