Low Back Pain Disability Research Articles

Efficacy of Static Magnetic Field Therapy on Pain Intensity, Functional Disability, Sleep Quality and Depressive Symptoms in Patients with Mechanical Neck and Low Back Pain.

Mechanical neck pain (MNP) and mechanical low back pain (MLBP) can have a negative impact on the quality of life of patients and may be associated with high levels of disability. Magnetic field therapy has been using in the treatment of various diseases. This study was conducted to assess the effects of Static Magnetic Field (SMF) therapy generated by neodymium magnets in patients with MNP and MLBP. In this randomized, double-blind, sham-controlled, crossover study, patients with MNP and MLBP were randomly assigned to either the magnetic band or sham band treatment groups. After the initial 2-week phase (with participants randomly assigned to either treatment or sham-control), both groups underwent a 1-week washout period. Subsequently, the groups were swapped and proceeded with a second 2-week phase. Visual Analogue Scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODI), Neck Disability Index (NDI), Insomnia Severity Index (ISI), and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the patients' pain severity, functional disability, sleep quality, and levels of depressive symptoms, respectively. Of the 30 subjects, 17 (56.7%) had MLBP, whereas 13 (43.3%) had MNP. Magnetic band treatment (MBT) resulted in a significant decrease in the VAS score (p < 0.001) in all patients. MBT led to a significant decrease in the ODI score (p = 0.009) in patients with MLBP. A significant decrease in the NDI score was found in MBT (p < 0.001) in patients with MNP. The improvement in ISI and PHQ-9 scores was also significantly higher in MBT (p < 0.001). For patients with MNP and MLBP who have not experienced sufficient benefits from conventional treatments, neodymium magnets can be considered as an alternative treatment option due to their significant properties.

Effects of pain neuroscience education combined with neuromuscular exercises on pain, functional disability and psychological factors in chronic low back pain: A study protocol for a single-blind randomized controlled trial.

Chronic low back pain (CLBP) is a prevalent health condition worldwide. Several therapeutic interventions aim to improve CLBP. Pain Neuroscience Education (PNE) helps patients better understand their pain from biological and physiological perspectives, which clinicians use to reduce pain and disability in patients with chronic musculoskeletal conditions. Neuromuscular exercises (NMS) are also treatments adopted in CLBP. This study will investigate whether PNE combined with an NMS program improves pain, functional and psychological outcomes more than NMS alone in patients with CLBP. In this single-blind randomized controlled trial, 60 patients (male and female; age range, 30-60 years) diagnosed with CLBP will be randomly assigned to one of the following groups: (1) PNE plus NMS (n = 30; 24 sessions of PNE plus NMS in a total of 8 weeks, 3 each week), and (2) NMS alone (n = 30; 24 sessions of NMS sessions in a total of 8 weeks, 3 each week). Outcome assessors will be blinded to the group allocation. The primary outcome will be pain. Secondary outcomes will be disability, fear-avoidance beliefs about work and physical activity, self-efficacy, exercise anxiety, and kinesiophobia. Outcomes will be assessed at baseline, after 8 weeks of intervention, and 6 months post-intervention. The findings of this RCT will help shed light on new treatment strategies to address the biopsychosocial dimensions of CLBP. The study protocol will be conducted in a clinical setting, offering the opportunity for future implementation in healthcare systems. Moreover, it will help clarify whether a combined treatment (PNE with NMS) is more effective than NMS alone for improving pain, functional and psychological outcomes in CLBP. Study registration: The study was prospectively registered in the Iranian Registry of Clinical Trials-IRCT20190427043384N2 (https://www.irct.ir/trial/69146). Registered on March 17, 2023.

Inpatient Rehabilitation is Effective for Severe Daily Activity Deficits Related to Chronic Low Back Pain.

Chronic low back pain disability (CLBPD) is a syndrome that includes pain, disability, emotional impairments, and social problems. The study was conducted to examine the effect of an inpatient rehabilitation program on the performance of everyday life tasks (daily activities), and report on pain in CLBPD patients with primary activities of daily living (ADL) deficits. In a retrospective cohort study, demographic and clinical data were retrieved from records of inpatients admitted consecutively to the program. Scores of the Spinal Pain Independence Measure (SPIM) and of changes in reported pain levels were used to assess improvement in the performance of daily activities and pain reduction. T-tests were used to assess the significance of score changes. Spearman's correlations and analysis of variance were used to assess relationships of SPIM gain and affecting factors. Ninety-nine patients were included. Daily task performance improved in 71 patients (71.7%). The SPIM score increased from 48.7 (SD 16.3) at admission to the rehabilitation program to 57.8 (SD 12.5) at discharge (P<0.001). The SPIM score at admission negatively affected SPIM gain (P<0.001). The SPIM gain was significant for admission SPIM scores of 50 or lower (P<0.05), but differences in SPIM scores were not as noticeable for patients with admission SPIM scores above 50. Relief in pain was reported in 59 patients (59.6%) and was not associated with function. The multidisciplinary rehabilitation program, which improved function and provided limited pain relief in inpatients with CLBPD primary ADL deficits, can be effective for the most severe CLBPD cases.

Study of correlation between arches of foot and lower back pain in Eastern India

Background: Low back pain is one of the most common disorders of the musculoskeletal system, leading to impaired function and decreased quality of life in many patients. Foot arch alterations may lead to structural changes and/or affect its load distribution. It should be noted that even slight elevations of the foot’s medial longitudinal arch above the norm may lead to changes in load and pressure distribution. Hence, it becomes important to find the relationship between low back pain and altered foot arch indices leading to improper body balance. Aims and Objectives: The aims and objectives of the study are to find any correlation between lower back pain and an altered foot arch index in the Eastern Indian population. Materials and Methods: A total of 60 subjects aged 20–40 years with varying degrees of low back pain were selected. Low back pain scores of the subjects were found using modified oswestry low back pain disability questionnaire. Footprints in standing position using ink were taken on graph paper and the foot arch indices were calculated. Results: 54.16% of the male and 36.11% of female participants had low arched feet, 20.83% of male and 52.78% of female participants had normal arched feet, and 25% of male and 11.11% of female participants had high arched feet with varying degrees of low back pain. 77.42% of the participants with minimal disability due to low back pain were having normal arched feet, 71.43% of the participants with moderate disability due to low back pain were having low arched feet, and 100% of the participants with severe disability due to low back pain were having either high or low arched feet. Conclusion: This study showed that people having either low or high arched feet are at an increased risk of developing acute or chronic low back pain at some stage in their lives. Knowledge of this risk factor might even help people to choose appropriate occupations in the future.

A Study of the Clinical Characteristics of Patients with Low Back Pain at a Single Center in Baghdad

Background: Low back pain is a prevalent and consequential problem in contemporary culture. In the early phases of their careers, many athletes who train particularly hard have considerable low back difficulties Aims of study is to enhance understanding and guide best management practices for those with or at risk of low back pain and to identify diverse aspects of clinical and epidemiological factors in Iraqis for low back pain. Patients and methods: A cohort of 440 individuals diagnosed with Low back pain (LBP) from the rheumatology department at Baghdad Teaching Hospital-Medical City in Baghdad province were involved in the current cross-sectional investigation. The sample consisted of 180 men and 260 women, with an average age of 45.7±14.8 years. The research was carried out from 12/October/2023 to 12 /March/2024. Results: All individuals in this study had LBP. The means age was 45 for the group of patients under consideration. 7 ± 14. 8 years. LBP had the highest incidence in the middle-aged (40-59 years 23%) and the lowest was recorded for the aged above 70 years (7. 5%). Females accounted for 59. 1% of the participants. Most of them; a percentage equivalent to 75. 5% were married. Approximately a third or 30% were employed while, 70.9% of the respondents were jobless. 6 % were overweight people and 77 % were non smokers in the study group. The mean age at the first complaint, visit and diagnosis of the disease were 43. 0 ± 14. 0 years (range: 11–75), 43. 3 ± 14. 2 years (range: McGregor observed that 11% to 78% of patients had some degree of in Continuation of Disturbances: Symptoms, defective vision, and 43. 5 ± 14. 2 years (range: 14–78),respectively. Intervertebral disc prolapse was the most frequent diagnosis among the patients with LBP (49. 8%), while infections were the least frequent (0. 2%). In the following aspects of the Oswestry Low Back Pain Disability Scores, majority participated as follows; 44. 3% with fairly severe pain intensity, 42% who require some help with personal care but mostly manage with it, 39. 5% who lift heavy weights but manage light to medium weights, 34. 1% who are prevented from walking more than 100 yards by their pain, 37. 5 The Analyzed Oswestry Low Back Pain Disability Score mean was 22. 22 ± 7. 26. Conclusion: LPB has a higher frequency among the female population

Chronic non-specific low back pain disability and depressive symptoms in working men and women: a cross-sectional study.

Chronic non-specific low back pain (LBP) is a serious public health issue that impairs the functional abilities of working men and women. The burden and experience of chronic non-specific LBP are largely influenced by psychological and psychosocial aspects. The objective was to investigate the association between the severity of chronic non-specific LBP disability and depressive symptoms in a sample of Croatian working active men and women with an age distribution from 35 to 65 years. The Roland Morris Disability Questionnaire (RMDQ) assessed disability, whereas the Beck Depression Inventory-II assessed depressive symptoms. During the routine outpatient visit self-reported RMDQ and BDI-II were completed from 203 recruited patients, divided into categories concerning disability scores. The median (IQR) age of 48.59 ± 6.48 was in the lower and the median (IQR) age of 50.65 ± 7.68 in the higher disability category. Disability was significantly associated (p < 0.05) with higher age (r = 0.177), working experience (r = 0.161), LBP duration (r = 0.195), greater pain intensity (r = 0.474 during activity, r = 0.227 at rest), and BDI-II score (r = 0.466). Higher BDI-II scores were associated with confirmatory answers on the 15th, 19th, and 22nd questions in RMDQ (p < 0.05). In patients with chronic non-specific LBP, higher degrees of disability were linked to severe depressive symptoms, aging, longer working experience, and increased pain intensity. These findings support pretreatment screening for depressive symptoms in order to develop individually customized and efficient multidisciplinary therapies.

The Comparison of Scar Mobilization Techniques with and without Core Stability Exercises on Scar Tissue Mobility and Lumbopelvic Pain

Abdominal adhesions and lumbopelvic pain can occur after a caesarean section. Many treatment approaches, such as injections, massage, surgical release, soft tissue release, strengthening, stretching and core stability exercises are available for abdominal scars. Physiotherapy treatments are considered safer and more convenient. The study aims to compare the effects of scar mobilization techniques with and without core stability exercises on scar tissue mobility and lumbopelvic pain. The study was a randomized clinical trial conducted at the Rafiqa Hospital and Fatima Hospital, Sargodha, Pakistan. A sample of 30 participants was allocated in Group A and B. Group A received scar mobilization and core stability exercises, while Group B received only scar mobilization, with both groups undergoing 3 sessions per week for total three weeks. The groups were assessed at baseline after the 5th and 9th sessions, using Oswestry Low Back Pain Disability Questionnaire (ODI), Numeric Pain Rating Scale (NPRS), Manual Scar Mobility Testing (MSMT), and Vancouver Scar Scale (VSS). Moreover, the data were analyzed using SPSS 25. The mean age of participants was 27.22 ± 4.21, and their body mass index was 27.10 ± 3.53. Both groups showed significant differences within the subject’s scores of disability, pain and scar mobility (p&lt;0.05). Between-group comparison of both groups at post-treatment II showed considerable improvement in pain scores (NPRS score, p&lt;0.05). Whereas non-significant results were in other outcome measures (disability and scar mobility p&gt;0.05) in post-treatment II. Scar mobilization techniques with core stability exercises were more effective than scar mobilization techniques alone in the conservative treatment of females with lumbopelvic and scar pain after caesarean section.

Release of scars improve pain, vertebral mobility and reduce the degree of disability in chronic low back pain

Release of scars improve pain, vertebral mobility and reduce the degree of disability in chronic low back pain

Multimodal Analgesia Approach in Acute Low Back Pain Management: A Phase III Study of a Novel Analgesic Combination of Etoricoxib/Tramadol.

Pain and disability management are crucial for a speedy recovery. Combining analgesics with different mechanisms of action provides greater pain relief with lower doses, promoting efficient multimodal analgesia. This study evaluated the efficacy and safety between two fixed-dose combinations (FDC): etoricoxib/tramadol compared to paracetamol/tramadol for the management of acute low back pain (LBP) in a 7-day treatment. We conducted a phase IIIb, prospective, randomized, and multicenter study in patients with acute LBP treated with etoricoxib 90mg/tramadol 50mg (one packet of granules diluted in 100ml of water, once a day [QD], for 7 days) or paracetamol 975mg/tramadol 112.5mg (one tablet of 325mg/37.5mg, three times a day [TID], for 7 days) to assess the efficacy (in terms of pain and disability improvement) and safety. One hundred and twenty-four patients were randomized to receive either etoricoxib/tramadol QD (n = 61) or paracetamol/tramadol TID (n = 63). From the magnitude of change in pain evaluations, differences were observed between the treatment groups at 3 [p = 0.054, CI 95% -0.648 (-0.010 to 1.306)] and 5days (p = 0.041). The proportion of patients with a 30% reduction in Visual Analogue Scale (VAS) score was statistically significant when comparing the treatment groups on the third day of follow-up [p = 0.008, CI 95% 0.241 (0.061-0.421)]. An improvement in LBP's disability to perform activities of daily routine (Oswestry and Roland-Morris questionnaires) was observed in both treatment groups. A total of 79 adverse events (AEs) (38 [48.1%] with etoricoxib/tramadol and 41 [51.9%] with paracetamol/tramadol) were reported. The most frequent AEs were nausea (17.7%) and dizziness (16.4%). The results show the clinical benefits of etoricoxib/tramadol FDC, such as the sparing effect of tramadol dose per day, early therapeutic response rate compared with paracetamol/tramadol; which translates into faster pain relief, better adherence, less tramadol drug dependency, and a reduction of related AEs incidence. ClinicalTrials.gov identifier, NCT04968158.

Effects of MLS Laser on pain, function, and disability in chronic non-specific low back pain: A double-blind placebo randomized-controlled trial.

Among non-pharmacological interventions, Multiwave Locked System (MLS) Laser therapy has been used in patients with several musculoskeletal pathologies and in combination with other therapeutical interventions. The effects of sole MLS therapy on pain and function in patients with chronic non-specific low-back pain are unknown. The objective of this study was to investigate the effects of MLS Laser therapy on pain, function, and disability in patients with chronic non-specific low back pain in comparison to a placebo treatment group. Forty-five patients were randomized into two groups: the MLS Laser group and the Sham Laser group, undergoing 8 sessions of either a MLS Laser therapy or a Sham Laser therapy, respectively. At the beginning of the therapy (T0), at the end of the therapy (T1), and 1 month after the end of therapy (T2) patients were assessed for low back pain (by means of a VAS scale), function (by means of kinematic and electromyographic assessment of a forward bending movement) and self-reported disability (by means of the Roland-Morris and Oswestry Disability questionnaires). There was a significant reduction of pain and disability in both groups at T1 and T2 in comparison with T0. At T2 patients in the MLS group showed a significantly lower pain in comparison with patients in the Sham group (VAS = 2.2 ± 2 vs. 3.6 ± 2.4; p< 0.05). No differences between the two groups were found for function and disability. Both MLS Laser and Sham Laser therapies lead to a significant and comparable reduction in pain and disability in patients with chronic non-specific low back pain. However, one month after treatment, MLS Laser therapy has been found to be significantly more effective in reducing pain as compared to sham treatment.

Comparing assessment methods of low back pain related disability in student circus artists: A cross-sectional study

BACKGROUND: Student circus artists put constant stress on their back. However, the presence of low back pain (LBP) and related disability in this population remains unclear. OBJECTIVES: To 1) examine LBP history in circus artists and compare related disability scores using the Oswestry Disability Index (ODI) and the Athlete Disability Index (ADI), and 2) examine the correlation between LBP-related disability scores, pain intensity and pain catastrophizing. METHODS: Thirty-three circus students completed an online survey on demographics, training history, and LBP. Participants reporting LBP filled the ODI, ADI, numerical pain rating scale (NPRS), and Pain Catastrophizing Scale (PCS). Descriptive statistics and Pearson’s correlation coefficients were used to assess the correlations between the ODI, ADI, NPRS, and PCS. RESULTS: There was a significant positive correlation between the ODI and ADI (r= 0.77, p&lt; 0.001) and between the NPRS and ADI (r= 0.52, p= 0.03), but no correlation between NPRS and ODI. While the PCS scores were significantly correlated with the NPRS ((r= 0.71; p&lt; 0.001) and the ADI (r= 0.51; p= 0.032), no correlation was observed between the PCS and ODI scores (p= 0.088). Based on the ODI scores, 94.44% of the artists reporting LBP were classified with mild disability, 5.56% moderate, and 0% severe disability as compared to 66.67%, 27.78% and 5.55% with the ADI, respectively. CONCLUSION: Our study highlights the potential of the ADI as an effective tool for assessing LBP-related disability in circus artists, supported by a strong correlation with the NPRS.

73. Defining the normative level of functional low back pain disability in the American population: A crowdsourced evaluation of the Oswestry disability index.

73. Defining the normative level of functional low back pain disability in the American population: A crowdsourced evaluation of the Oswestry disability index.

Describing functional low back pain disability in the American population: a crowd-sourced evaluation of the Oswestry disability index

BACKGROUND CONTEXTThe Oswestry disability index (ODI) is widely utilized as a patient reported outcome (PRO) tool to assess patients presenting with low back pain (LBP) and following thoracolumbar spine surgery. No primary study has calculated the baseline range of ODI values in the diverse American population. Establishing age-adjusted normative values for ODI in the American population is crucial for assessing the utility of treatment strategies. PURPOSEThe purpose of this study is to describe the baseline range of functional low back disability as measured by the ODI in an American population. STUDY DESIGN/SETTINGCross-Sectional Observational Study. PATIENT SAMPLEA total of 1214 participants were recruited from the United States in January 2024 using a combination of the Connect and PrimePanel platforms by CloudResearch to complete a survey administered on a RedCap online database. The survey consisted of 10 demographic questions and the 10 ODI survey questions. The distribution of the survey was designed to obtain approximately 100 respondents in each of the following age groups: 18–29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89. The distribution of the sample was similarly designed to match the United States Census racial data with 78.1% White, 13.9% Black, and 7.9% other. OUTCOME MEASURESOswestry disability index (ODI). METHODSA crowd-sourcing platform called Cloudresearch was used to collect a representative sample of the US population by answering questions of the Oswestry disability questionnaire (ODQ), a 10-question survey. RESULTSThe final sample size was 797 participants including 386 (48.4%) males and 411 (51.6%) females; 169 participants were excluded that did not complete the survey and an additional 248 were excluded for failing attention check questions. The overall mean ODI score for the combined age groups was 14.35 (95% CI [13.33, 15.37]). The mean ODI scores increased with age, with the highest mean ODI in ages 70 to 79 at 18.0 (95% CI [14.76, 21.24]). Female participants reported higher mean ODI scores than their male counterparts in the 18 to 29 age group (p=.01), 50 to 59 age group (p=.01), and 60 to 69 age group (p=.02). Additionally, a weak positive correlation was found between Body Mass Index (BMI) and ODI scores (r = 0.22, p<.001). CONCLUSIONOur findings demonstrate a clear trend of increased disability with age. This study describes the baseline range of functional low back pain disability in the United States population. By defining these parameters, healthcare professionals can better tailor age and sex-specific interventions to manage disability in the aging US population, ultimately improving patient care and both operative and nonoperative treatment plans for LBP-related thoracolumbar pathology.

Effectiveness of biobehavioral therapeutic education in chronic low back pain intensity and disability: a systematic review

Background: Chronic low back pain (CLBP) is a prevalent musculoskeletal issue that could lead to significant disability. CLBP involves persistent pain and psychological factors contributing to its complexity. Therapeutic education combining cognitive-behavioral approaches may aid in managing CLBP. Objectives: This systematic review evaluates the efficacy of therapeutic education based on a biobehavioral approach in modifying beliefs and promoting active coping strategies in CLBP patients. Methods: Following PRISMA guidelines, we searched PubMed, EBSCO host, and Google Scholar for randomized controlled trials (RCTs) and quasi-experimental studies from March 27 to April 16, 2022, with an update on June 15, 2024. Inclusion criteria focused on adults with CLBP undergoing therapeutic education aimed at behavioral modification. Methodological quality was assessed using the PEDro scale, and risk of bias was evaluated using RoB 2.0. Results: Out of 532 studies, four met the inclusion criteria. The interventions combined therapeutic education with therapeutic exercise or conventional physical therapy. Pain intensity and disability were the main outcomes measured. One study found significant improvements in pain and disability, while others showed trends towards improvement without statistical significance. The quality of evidence was very low. Conclusion: Combining therapeutic education with active coping strategies and other therapies may reduce pain intensity and disability in CLBP patients. However, the evidence quality is very low, highlighting the need for further research.

Application of polyetheretherketone rod semi-rigid pedicle screw internal fixation in lumbar non-fusion surgery

To investigate the effect of Polyetheretherketone (PEEK) rod semi-rigid pedicle screw fixation system in lumbar spine non-fusion surgery. A total of 74 patients with tow-level lumbar degenerative diseases who underwent surgery from March 2017 to December 2019 were divided into PEEK rod group and titanium rod group. In the PEEK rod group, there were 34 patients, including 13 males and 21 females, aged from 51 to 79 years old with an average of (62.4±6.8) years old;There were 1 patient of L1-L3 segments, 7 patients of L2-L4 segments, 20 patients of L3-L5 segments and 6 patients of L4-S1 segments. In the titanium rod group, there were 40 patients, including 17 males and 23 females, aged from 52 to 81 years old with an average of (65.2±7.3) years old;There were 3 patient of L1-L3 segments, 11 patients of L2-L4 segments, 19 patients of L3-L5 segments and 7 patients of L4-S1 segments. The general conditions of operation, such as operation time, intraoperative blood loss, postoperative drainage was recorded. The visual analogue scale (VAS) for low back pain and Oswestry disability index (ODI) were compared in preoperatively and postoperatively(3 months, 12 months and last follow-up) between two groups. The change of range of motion (ROM) was observed by flexion and extension x-ray of lumbar. All patients successfully completed the operation. The follow-up time ranged from 22 to 34 months with an average of(26.8±5.6) months. The operative time (142.2±44.7) min and intraoperative blood loss(166.5±67.4)ml in PEEK group were lower than those in titanium group [(160.7±57.3) min、(212.8±85.4) ml](P<0.05). There was no significant differences in postoperative drainage between the two groups (P>0.05). At the final follow-up visit, in PEEK group and titanium group VAS of low back pain[(0.8±0.4) points vs (1.0±0.5) points], VAS for leg pain [ (0.7±0.4) points vs (0.8±0.5) points] and ODI [(9.8±1.6)% vs (12.1±1.5)%] were compared with preoperative [ (5.8±1.1) points vs (6.0±1.1)points], [ (7.2±1.7) points vs (7.0±1.6) points], [(68.5±8.9)% vs(66.3±8.2)%] were significantly different(P<0.05). There was no significant difference in VAS scores between the two groups at each postoperative time point (P>0.05). At 3 months after surgery, there was no difference in ODI between the two groups (P>0.05). There were significant differences in ODI between PEEK group and titanium rod group at 12 months [(15.5±2.1)% vs (18.4±2.4)%] and at the last follow-up [(9.8±1.6)% vs (12.1±1.5)%] (P<0.05). The total range of motion (ROM) of lumbar decreased in both groups after surgery. At 12 months after surgery and the last follow-up, the PEEK group compared with the titanium rod group, the total range of motion of lumbar was statistically significant (P<0.05). The range of motion (ROM) of the fixed segments decreased in both groups after surgery. The ROM of the fixed segments in PEEK group decreased from (9.5±4.6)° to (4.1±1.9)° at the last follow-up (P<0.05), which in the titanium rod group was decreased from (9.8±4.3)°to (0.9±0.5)° at the last follow-up (P<0.05). The range of motion (ROM) of upper adjacent segment increased in both groups, there was statistical significance in the ROM of upper adjacent segment between the two groups at 12 months after surgery and the last follow-up, (P<0.05). There was no screw loosening and broken rods in both groups during the follow-up period. The PEEK rod semi-rigid pedicle screw internal fixation system used in lumbar non-fusion surgery can retain part of the mobility of the fixed segment, showing comparable short-term clinical efficacy to titanium rod fusion. PEEK rod semi-rigid pedicle screw internal fixation system is a feasible choice for the treatment of lumbar spine degenerative diseases, and its long-term efficacy needs further follow-up observation.

Meta Analysis: Effects Of Mckenzie Exercise And Other Treatment Techniques In Reducing Pain and Disability In Chronic Nonspecific Low Back Pain

Background Low back pain (LBP) is rising globally due to increase in population and ageing. In adults below 45 years of age, work-related injury leads to nonspecific pain resulting in disability. Exercise therapy has proven to be effective in reducing pain and associated disability in these patients. McKenzie exercises focus on repeated end-range movement and posture correction, thereby reducing pain and disability. This study aims to compare the effectiveness of McKenzie exercise with other techniques in reducing pain and disability in nonspecific chronic LBP (NSCLBP). Objectives To compare the effect of alternate treatment approaches and McKenzie exercises in nonspecific chronic low back pain. Methods Studies that satisfied the inclusion and exclusion criteria for the review were found by searching databases like Google Scholar, Pub Med and Cochrane CENTRAL. This study comprised randomized controlled trials that compared McKenzie treatment with other therapeutic approaches for treating NSCLBP. Two independent reviewers extracted the data and evaluated the trials' quality. Forest plots were used to display the results. Results Eleven full-text articles were included in this study for review in order to conduct a meta-analysis and qualitative analysis. The meta-analysis of pain and functional impairment related to back pain comprised ten studies each. When comparing patients undergoing McKenzie treatment to other treatment techniques, there was a slight overall decrease in the intensity of low back pain (SMD: -0.83 [95% CI: -1.11, -0.55], I2= 80.8%; p&lt; 0.000). After doing McKenzie exercises, low back patients' functional impairment did not improve in comparison to other therapy methods (SMD: 0.07 [95% CI: -0.54, 0.68], I2= 71.5%; p&lt; 0.000). Conclusion McKenzie exercise is equally effective to other manual therapy techniques but slightly effective than passive treatments in decreasing pain &amp; disability in NSCLBP.

Central sensitization-related symptoms and their relationship to disability in prevalent chronic musculoskeletal pain: A cross-sectional study

BackgroundCentral sensitization (CS) has an important role in chronic musculoskeletal (MSK) pain, which is one of the leading causes of disability worldwide. ObjectivesTo investigate the relationship between CS-related symptoms and disability in chronic MSK pain. DesignMulti-center cross-sectional survey. MethodsDemographic and clinical variables including location, duration, and severity of pain were recorded. In the examination of disability, Istanbul Low Back Pain Disability Index for low back pain, Neck Pain and Disability Scale for neck pain, Quick Disability of the Arm, Shoulder, and Hand for shoulder/upper extremity pain, and Knee Injury and Osteoarthritis Outcome Score for knee pain were used. CS-related symptoms were investigated via the central sensitization inventory (CSI). Based on CSI scores, patient data were compared using the T test and an ANOVA. The association between CSI and selected variables was investigated using Pearson correlation and multivariate regression analysis. ResultsThe mean CSI score of five hundred participants was 40.46 (SD: 15.87). Patients with CSI≥40 were found to have higher levels of pain and disability and a poorer quality of life (p < 0.05). In ANOVA, significant differences between groups were observed in CS severity levels for VAS, symptom duration, and all clinical scores (p < 0.01). In the multivariate regression analysis, CSI and VAS scores were found to be related to disability in all pain groups, while pain duration was effective only in the change of knee disability. ConclusionCS-related symptoms, which are related to increased pain and disability, should be closely monitored in patients with chronic MSK pain.

Characteristics and outcomes of patients with low back pain with and without radiating leg pain following the GLA:D back program

BackgroundSome patients with low back pain (LBP) also report radiating leg pain which is a prognostic factor for poorer clinical outcomes. We aimed: 1) to compare the baseline characteristics of patients with LBP with - (LBP + leg pain) and without radiating leg pain (LBP - alone); 2) to investigate whether patients with LBP + leg pain show similar post-treatment outcomes as compared to LBP – alone, after participation in an exercise and patient education program, i.e. the GLA:D Back program. MethodsThe patient sample included 3508 patients in the GLA:D Back program between March 2018 and August 2022. The outcomes were mean changes in LBP intensity, back-related activity limitation, self-efficacy and fear of movement measured from baseline to 3, 6 and 12 months. Baseline characteristics were compared with descriptive statistics, and linear mixed models were used to estimate group differences in changes from baseline to 3-, 6- and 12 months. Results1915 (55%) of the patients were in the group LBP- alone and 1593 (45%) in the LBP + leg pain. The LBP + leg pain group displayed higher STarT back classification (greater risk of chronicity) compared to the LBP–alone. The LBP + leg pain group showed almost similar improvements in all outcomes compared to LBP – alone after the GLA:D Back program. ConclusionIn long-lasting (chronic) LBP patients, the LBP + leg pain group improved to the same extent as LBP - alone regarding LBP intensity, disability, and fear of movement following an exercise and patient education program, GLA:D Back.

Predictors of response in PROMIS-global in a chronic low back pain specialty clinic: STarTBack and chronic overlapping pain conditions.

Tools, such as the STarTBack Screening Tool (SBT), have been developed to identify risks of progressing to chronic disability in low back pain (LBP) patients in the primary care population. However, less is known about predictors of change in function after treatment in the specialty care population. We pursued a retrospective observational cohort study involving LBP patients seen in a multidisciplinary specialty clinic to assess which features can predict change in function at follow-up. The SBT was administered at initial visit, and a variety of patient characteristics were available in the chart including the presence of chronic overlapping pain conditions (COPCs). Patient Reported Outcomes Measurement Information System-10 (PROMIS-10) global physical health (PH) and global mental health (MH) were measured at baseline and at pragmatic time points during follow-up. Linear regression was used to estimate adjusted associations between available features and changes in PROMIS scores. 241patients were followed for a mean of 17.0 ± 7.5months. Mean baseline pain was 6.7 (SD 2.1), PROMIS-10 global MH score was 44.8 (SD 9.3), and PH score was 39.4 (SD 8.6). 29.7% were low-risk on the SBT, 41.8% were medium-risk, and 28.5% were high-risk. Mean change in MH and PH scores from baseline to the follow-up questionnaire were 0.86 (SD 8.11) and 2.39 (SD 7.52), respectively. Compared to low-risk patients, high-risk patients had a mean 4.35points greater improvement in their MH score (p= 0.004) and a mean 3.54points greater improvement in PH score (p= 0.006). Fewer COPCs also predicted greater improvement in MH and PH. SBT and the presence of COPC, which can be assessed at initial presentation to a specialty clinic, can predict change in PROMIS following treatment. Effort is needed to identify other factors that can help predict change in function after treatment in the specialty care setting.

Importance of lumbar instability in the study of associations between muscle morphology, pain, and disability in chronic low back pain.

The purpose of this study was to (1) evaluate the relationship between lumbar extensor muscle morphology, with pain and disability in patients with chronic low back pain (CLBP) and (2) compare these relationships in subgroup of CLBP with and without lumbar structural segmental instability. This cross-sectional study included 183 patients with CLBP. Standing lateral lumbar flexion/extension radiographs were used to assess lumbar structural segmental instability. Lumbar multifidus (MF), erector spinae (ES), and psoas major (PM) morphology were determined from axial magnetic resonance imaging. Associations between lumbar muscle morphologies and patient pain and disability were evaluated in two groups with and without lumbar instability. Patients' disability was negatively associated with PM total cross-sectional area (beta = -22.82, 95%CI = -37.05 to -8.59) and functional cross-sectional area (beta = -23.45, 95%CI = -37.81 to -9.09). MF morphology was negatively associated with disability in the lumbar instability group. Pain intensity was only associated to PM total cross-sectional area (Beta = -3.33, 95%CI = -6.43 to -2.24) and functional cross-sectional area (Beta = -3.22, 95%CI = -6.40 to -0.05) only in the lumbar instability group. PM atrophy was associated with greater disability and pain in CLBP, but MF atrophy was associated with greater disability in CLBP patients with lumbar structural segmental instability.