Therapy For Back Pain Research Articles

Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners

BackgroundCore stability training has grown in popularity over 25 years, initially for back pain prevention or therapy. Subsequently, it developed as a mode of exercise training for health, fitness and sport. The scientific basis for traditional core stability exercise has recently been questioned and challenged, especially in relation to dynamic athletic performance. Reviews have called for clarity on what constitutes anatomy and function of the core, especially in healthy and uninjured people. Clinical research suggests that traditional core stability training is inappropriate for development of fitness for heath and sports performance. However, commonly used methods of measuring core stability in research do not reflect functional nature of core stability in uninjured, healthy and athletic populations. Recent reviews have proposed a more dynamic, whole body approach to training core stabilization, and research has begun to measure and report efficacy of these modes training. The purpose of this study was to assess extent to which these developments have informed people currently working and participating in sport.MethodsAn online survey questionnaire was developed around common themes on core stability training as defined in the current scientific literature and circulated to a sample population of people working and participating in sport. Survey results were assessed against key elements of the current scientific debate.ResultsPerceptions on anatomy and function of the core were gathered from a representative cohort of athletes, coaches, sports science and sports medicine practitioners (n = 241), along with their views on effectiveness of various current and traditional exercise training modes. Most popular method of testing and measuring core function was subjective assessment through observation (43%), while a quarter (22%) believed there was no effective method of measurement. Perceptions of people in sport reflect the scientific debate, and practitioners have adopted a more functional approach to core stability training. There was strong support for loaded, compound exercises performed upright, compared to moderate support for traditional core stability exercises. Half of the participants (50%) in the survey, however, still support a traditional isolation core stability training.ConclusionPerceptions in applied practice on core stability training for dynamic athletic performance are aligned to a large extent to the scientific literature.

The evidence of physical activity and training for the therapy of chronic non-specific back pain

The evidence of physical activity and training for the therapy of chronic non-specific back pain

Randomized Controlled Trial of Nurse-Delivered Cognitive-Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain

This study evaluated a nurse-delivered, telehealth intervention of cognitive-behavioral therapy (CBT) versus supportive psychotherapy for chronic back pain. Participants (N = 61) had chronic back pain (pain “daily” ≥6 months at an intensity of ≥4 of 10 scale) and were randomized to an 8-week, 12-session, CBT or to supportive care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ). Secondary outcomes included the numeric rating scale (NRS) and the Patient Global Impressions Scale (CGI). CBT participants (n = 30) showed significant improvements on the RMDQ (mean = 11.4 [SD = 5.9] vs 9.4 [SD = 6.1] at baseline and post-treatment, respectively, P < .05; d = .33), NRS (mean = 4.9 [SD = 2.1] vs 4.0 [SD = 1.9], respectively, P < .05; d = .45), and on the CGI (39.1% reporting “much improved” or “very much improved”). SC participants (n = 31) also showed significant improvements on the RMDQ (mean = 11.1 [SD = 5.4] vs 9.1 [SD = 5.2], respectively, P < .05; d = .38), the NRS, (mean = 5.0 [SD = 1.9] vs 3.8 [SD = 2.1], respectively, P < .05; d = .60), and 26.7% reporting “much improved” or “very much improved” on the CGI. Between groups comparisons of CBT and SC showed no differences on the study outcomes (Ps > .10). The results suggest that telehealth, nurse-delivered CBT, and SC treatments for chronic back pain can offer significant and relatively comparable benefits. PerspectiveThis article describes the benefits of training primary care nurses to deliver evidence-based behavioral therapies for low back pain. Because of the high prevalence of chronic pain and the growing emphasis on nonopioid therapies, training nurses to provide behavior therapies could be a cost-effective way to improve pain management.

Biologic therapies to enhance intervertebral disc repair.

Degenerative disc disease is a progressive, chronic disorder with strong association to pain, where the dysregulated tissue environment signals disc cells, thereby leading to a low inflammatory process and slow extracellular matrix degradation and fibrosis in a perpetual vicious cycle, generating a structural and functional failure of intervertebral disc joint (IVDJ). Among current biologic therapies, there is an emerging minimally invasive strategy that consists of infiltrating plasma rich in growth factors, a safe and efficacious therapeutic approach for other musculoskeletal degenerative conditions. This review summarizes the homeostasis and degeneration of IVDJ, discusses some results on basic science and therapeutic use of platelet-rich plasma products and advances an alternative minimally invasive biologic therapy in IVDJ degeneration and chronic back pain.

The chondroprotector mucosat in an integrated approach to the treatment of nonspecific back pain

A nonspecific back pain is in the vast majority of all possible cases of dorsopathies. The sources of back pain may be myogenic dysfunction, intervertebral disc pathology or osteoarthritis of the archicular (facet) joints of the spine, including myofascial pain syndrome. A differentiated approach to the treatment of spondylarthrosis is still an unsolved problem. The article discusses important issues of integration of non-drug treatment methods and drug therapy of nonspecific back pain in patients with facet syndrome. Special attention is paid to SYSADOA group chemicals, in particular chondroitin sulfate (mucosat). These drugs have proven analgesic and anti-inflammatory effects and also are able to improve the structure of the cartilaginous tissue, slowing the progression of the disease.

Acupuncture for Back Pain in Colon Cancer: A Case Report

Introduction: The research evidence supports the effectiveness of acupuncture as an alternative or supplementary therapy for back pain and some of musculoskeletal pains. On the other hand, the use of opioids in the management of cancer pain is common. The effectiveness of acupuncture on the amount of pain and the level of cortisol in opioid-dependent patients has not been addressed so far. Case Presentation: A 54-year-old man with metastatic cancer under chemotherapy and methadone maintenance treatment after 4 weeks of assessment at baseline received an auricular acupuncture treatment for 1 month. Saliva Cortisol Index was evaluated, using Salvi tests and the pain level was evaluated twice a week through a visual analog scale (VAS). Data were analyzed, using multiple baseline method in the form of pattern A-B. Conclusions: Primary outcome showed that cortisol levels decreased significantly during the acupuncture treatment. Secondary outcomes showed that acupuncture was accompanied by a decrease in the back pain. These findings, in addition to confirmation of the effectiveness of acupuncture on psychological and biological indicators, indicate the role of complementary therapies in cancer management and its side effects.

ICER reports on cognitive and mind-body therapies for back pain

ICER reports on cognitive and mind-body therapies for back pain

O1-6-12. Cauda equina conduction time as a test for lumber spinal stenosis

We examined the cauda equina conduction time (CECT) in 20 patients (11 male), average age, 73 years, low back pain therapy criterion score of Japan orthopaedic Association (JOA score), 17 points, and Oswestry Disability Index (ODI), 19 points and aged matched 17 healthy volunteers. Magnetic Augmented Translumbosacral Stimulation (MTATS) at L1 and S1 levels elicited a compound muscle action potential (CMAP) recordable from bilateral abductor hallucis muscle. We calculated the CECT as the difference between the latencies of CAMPs elicited by stimulation at L1 and S1 level. We divided the patients into the two groups, A group with a longer CECT (average, 7.4 ms) and B group with a shorter CECT (average, 5.2 ms). Statistical analyses of CECT showed a significant difference between the A group and healthy volunteers, a significant negative correlation with JOA score and a tendency to increase with a higher point of ODI. In conclusion, CECT using MATS coil serves usefully in physiologic assessments of lumbar canal spinal stenosis.

Pilates and mobilization methods in therapy for low back pain among pregnant women

Pilates and mobilization methods in therapy for low back pain among pregnant women

連載第7回 背部痛 理学療法診療ガイドライン

連載第7回 背部痛 理学療法診療ガイドライン

Some aspects of the pathogenetic therapy of back pain

Some aspects of the pathogenetic therapy of back pain

Socioanthropological contributions to physical therapy in chronic back pain

Abstract Introduction: The high prevalence of chronic back pain is related to biopsychosocial factors. In this respect, pain is understood as a multifactorial phenomenon made unique by the previous ideas of each individual. Thus, the present study aimed Objective: To understand the experience of chronic back pain and the effectiveness of physiotherapeutic approaches to support new care strategies. Methods: In terms of qualitative research, a comprehensive approach was adopted using the theoretical and conceptual framework developed in the fields of anthropology and health. The sample consisted of 13 women residing in the municipality of Várzea Grande, Mato Grosso state (MT), Brazil, over 40 years old, homemakers, diagnosed with chronic back pain, treated at the Univag clinical school and who had completed physiotherapy more than six months previously. Results: Data analysis indicated that more traditional forms of outpatient physiotherapy prompted a significant improvement in chronic back pain. However, because the condition is chronic, all patients relapsed and their pain and dysfunctional conditions returned. Conclusion: Multiple factors influence the experience of chronic back pain and the constant self-management required forms a circular relationship between objective and subjective elements. On the other hand, by disregarding these elements, physiotherapeutic approaches provide predominantly technical and scientific care far removed from the experience of the affected subject. In this respect, the chronic condition requires long-term care, whereby the focus should shift from the pursuit of a cure to the care model.

Возможности хондроитина сульфата и глюкозамина в качестве адъювантной терапии хронической боли в спине

Возможности хондроитина сульфата и глюкозамина в качестве адъювантной терапии хронической боли в спине

Oxygen-ozone therapy: our experience in the treatment of hard-root conflicts

Lower back pain and sciatica are clinical symptoms with debilitating effects on the quality of life; they are extremely common in the population. The treatment of patients affected by sciatica, and in particular of those incurred by herniated discs, may be medical, physiatric, percutaneous minimally invasive surgery. In recent years, for the treatment of disc-radicular conflicts the Oxygen-Ozone (O&lt;sub&gt;2&lt;/sub&gt;-O&lt;sub&gt;3&lt;/sub&gt;) therapy is spreading to a more and more significant extent. We report our experience with O&lt;sub&gt;2&lt;/sub&gt;-O&lt;sub&gt;3&lt;/sub&gt; therapy in the treatment of herniated lumbar discs, evaluating the efficacy of the therapy in lower back pain and sciatica. We treated 32 patients with paravertebral intramuscular infiltrations of about 15 cc of the mixture of O&lt;sub&gt;2&lt;/sub&gt;-O&lt;sub&gt;3&lt;/sub&gt; at a concentration of 30 µg/cc: 66.6 % of the patients had a positive response to the treatment.

The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain

Background:Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms.Objective:The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain.Methods:Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions.Results:Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions.Conclusions:There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.

HF10 Therapy for Chronic Back Pain in Patients with Nonoperated Kyphoscoliosis: The Importance of Preoperative Assessment

Dear Editor, Severe kyphoscoliosis is a deformity with fixed spinal vertebrae that does not allow traction, suspension, or side bending of the spine [1]. Treatment of rigid scoliosis in adults involves correction of complex three-dimensional deformities and restoring balance to the spine but is challenging due to a high rate of associated neurological complications [2]. Spinal cord stimulation (SCS) involves a minimally invasive procedure and might be an alternative pain-relieving therapeutic option with lower risks than spinal correction surgery, especially in patients with increased preoperative risk factors [3]. SCS delivered at 10kHz (HF10) may be preferable over conventional SCS for treatment of back pain [4], but studies examining its use in patients with kyphoscoliosis are lacking. We describe a patient with severe kyphoscoliosis who suffered from back pain for many years but refused spinal correction surgery. A treatment with high-frequency SCS diminished the burden of pain, and the patient was able to return to work. To our knowledge, this is the first report of an “unoperated back” patient who was efficiently treated with high-frequency SCS. A woman age 57 years presented with severe idiopathic kyphoscoliosis and progressive therapy-resistant back pain …

A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain

ObjectiveTo identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP). MethodsProspective observational study. ParticipantsOne hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic. Main outcome measuresPain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ). ResultsThe Fear-Avoidance Beliefs Questionnaire work subscale results (FABQ-work; odds ratio [OR]=0.27, 95% confidence interval [CI] 0.13–0.56, p<0.001) and extraspinal pain (OR=0.35, 95% CI 0.17–0.74, p=0.006) were independently associated with a decreased response to conventional physical therapy for CLBP. ConclusionWe identified high FABQ-work and extraspinal pain scores as key determinants of a worse response to physical therapy among CLBP patients, supporting the need for a special rehabilitation program for this subgroup.

Selected Aspects of Mental Health of Elderly Patients with Chronic Back Pain Treated in Primary Care Centers.

BackgroundImprovement of the effectiveness and efficiency of chronic back pain therapy is a continuing challenge on an international scale. The aim of the present study was to tentatively assess mental health of patients with chronic back pain treated in primary care centers.Material/MethodsThe study enrolled 100 persons over 50 years of age. The back pain group consisted of 53 patients with chronic back pain and the control group consisted of 47 pain-free persons. The assessment of mental health used a Polish version of the international Goldberger’s General Health Questionnaire (GHQ-28). ANOVA (1- and 2-factor) analysis of variance, Tukey’s test, and Pearson’s simple correlation were used to analyze the significance of differences, with the significance level set at α=0.05.ResultsAll patients with chronic back pain, regardless of their age and gender, displayed poorer mental well-being compared to the control group: their overall score was higher by over 7 points than in persons without back pain (F1.96=14.8; p<0.001). Men with back pain were significantly more susceptible to depression than women (F2.96=5.5; p<0.05), compared to the control group. The duration of back pain also showed a significant (p<0.05) direct correlation with the overall mental health score from the questionnaire. Mental health was considerably poorer among patients occasionally (p<0.001) and regularly (p<0.05) consuming analgesics than among persons who did not do so.ConclusionsThe study revealed that mental health was markedly poorer in patients with chronic back pain than in healthy controls. A preliminary assessment of aspects of mental health should be given more attention in the rehabilitation of patients with chronic back pain treated in primary care center outpatient clinics.

No Clinical Benefit for Early Physical Therapy in Recent-Onset Low Back Pain

Increasing use of imaging, opioids, and interventions (both percutaneous and surgical) in patients with low back pain is expensive and is not associated with better outcomes. Early physical therapy (PT) has been proposed to avoid these interventions, but clinical practice guidelines recommend against such use (NEJM JW Gen Med Nov 15 2007 and Ann …

Failed surgical therapy for chronic back pain and sciatica may be due to hypofunction of the sympathetic nervous system

To describe a distinctive pharmacological treatment for chronic pelvic pain and sciatica after spinal surgery with a laminectomy and spinal fusion failed to provide relief.Dextroamphetamine suflate was prescribed to a woman with a history of chronic back pain which was attributed to a ruptured disc. The pain was still unbearable after surgery.After adjusting dosage, within three months of the correct dose, 25 mg twice a day, relief was provided and has persisted for ten months.Chronic pelvic pain and sciatica both may be symptoms of hypofunction of the sympathetic nervous system. In addition, with other pain symptoms, this can be effectively treated with sympathomimetic amines.