Types Of Low Back Pain Research Articles

Risk Factors for Low Back Pain and Sciatica

So far, eight prospective studies and 50 cross-sectional or retrospective studies have focused on risk factors for low back syndromes. Half of these have been published during the 1980s. Hard physical work and, in particular, frequent lifting and postural stress are likely to result in disc degeneration, low back pain and sciatica. Physical strain may also have prophylactic effects, as physical leisure activity and muscular strength are negatively associated with the risk of low back pain. Much evidence points to driving motor vehicles being causally associated with low back pain and sciatica. A probably causal relationship exists between body height and risk of sciatica, but height is not necessarily predictive of other types of low back pain. Obesity, smoking, psychological distress and poor general health also carry increased risk of low back pain, but their causal role is questionable. Although none of the suspected risk factors can be described as having been conclusively investigated epidemiologically, the results of published studies show that there are modifiable factors contributing to low back pain. The overall potential of primary prevention is great if adequate tools for intervention can be developed.

Conservative Therapy for Low Back Pain

Conservative therapies for low back pain (LBP) entail expense, work loss, and risk of side effects. Because many competing modalities have been advocated, 59 therapeutic trials were examined for adherence to 11 methodological criteria. Common problems included failure to randomize subjects, use "blind" observers, measure compliance, and adequately describe co-interventions. Applicability of many studies was unclear because of inadequate descriptions of patients, interventions, and relevant outcomes. Flexion exercises, administration of each of three drugs, one traction method, and certain manipulations were each supported by single studies of reasonable validity, but the importance of the results and their applicability to particular types of LBP were unclear. Valid trials supporting use of corsets, bed rest, transcutaneous nerve stimulation, and conventional traction were not found. Better methodological rigor is possible with newer techniques for ensuring blindness to therapy, measuring compliance, and assessing outcomes.

Long Term Follow-up of Patients with Idiopathic Scoliosis Treated Surgically A Preliminary Subjective Study

An 8 to 14-year follow-up study of 51 surgically-treated patients with idiopathic scoliosis was performed to determine the impact upon their total life styles, and the differences in comparable but non-surgically-treated patients. Forty-nine per cent were already married and raising families and 70 per cent had been educated beyond high school. Ninety-four per cent were actively employed although 20 per cent had met with some type of job discrimination. None of the unemployed was rejected because of back symptoms. Eighty-six per cent of the patients experienced either no back symptoms or just an annoying but nonrestrictive type of low back pain. Most of the patients experiencing significant back pain were found to have tight hamstrings. Only 4 per cent of the patients required hospitalization for back symptoms and another 4 per cent relied on the use of a lumbar corset to relieve their back strain. Seventy-eight per cent of the patients were quite active in sports and other strenuous activities. Fifty-one per cent of the patients were motivated for cosmetic reasons to undergo the corrective surgery. Postoperatively, 33 per cent were still self-conscious of their scar and 43 per cent were bothered with a residual deformity. Only 10 per cent, however, expressed an overall dissatisfaction with the total result.

A Controlled Double-Blind Studies of Alclofenac in Low back pain

In order to compare the effect of alclofenac with that of diclofenac sodium, a doubleblind study was performed with 57 out-patients with chronic low back pain. Alclofenac was proved to be more effective in the treatment of advanced functional low back pain and severe degenerative low back pain as well. It is considered that alclofenac is one of the useful medicines in the treatment of out-patients with any type of low back pain in view of its marked therapeutic effects and rare side effects.

Back Injuries: Introduction

Low back pain is with us always. It was just as prevalent thirty-five years ago as it is today, and if this writer's experience went back one hundred years he probably would have found it just as prevalent then, although the busy pioneer had little time to think of his back. There is no field in medicine or surgery where changing styles in treatment have been so numerous as in this condition of low back pain. With the advent of more powerful and faster transportation, stupendous lawsuits became the vogue and “railway spine” was the most frequent diagnosis assigned to low back pain. With the coming of the industrial age, especially when employees' compensation laws became an economic factor, our diagnostic nomenclature for low back pain increased amazingly, ranging from the old “sacroiliac sprain” to the present “herniated disk.” New and ever newer methods of treatment, often complicated and often surgical in approach, have been evolved to meet these changing styles in diagnosis. In many instances worthwhile advances in surgery have resulted, with great relief to certain persons with definite organic lesions. But to weed out those who need these more complicated or radical surgical procedures is the greatest problem confronting surgeons today. We must not lose sight of the fact that the same types of low back pain were prevalent among our fathers, grandfathers, and great-grand-fathers, who, in spite of this and deprived of the benefits of modern surgery, survived and built a great country at the expense of more and longer hard, back-splitting labor than our present generation ever dreamed of performing. One great surgeon has written: “Ruptured intervertebral disks … are, in fact, among the most frequent lesions treated surgically.” We doubt this statement, and yet it shows the great tendency to surgical attack on low back pain. We should pause and ask ourselves the question: “Has our surgical enthusiasm made the human race more back-conscious than it was in the earlier generations?” I repeat what I have written before: when indicated by such definite neurological findings that the diagnosis cannot be mistaken, the removal of cord tumors, osteomas, or protruding disks is a gift from God. But to approach all low back pains with operation uppermost in mind is to overlook the psychogenic, the postural, the muscle imbalance, and the numerous constitutional causes that are the predominant factors in the average run of painful low back cases. For these, operations on the spine or cord are never indicated. Even if a ruptured protruding disk is found and removed—a disk which, from the history in many cases, must have protruded for years—this does not always rule out the existence of the above conditions and does not necessarily mean that the patient henceforth will be free of low back pain. There was a time when the removal of all foci of infection seemed to offer the hope of eradicating low back pain from suffering humanity.