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pain low back guideline review

Aron Downie, Mark Hancock, Hazel Jenkins, Rachelle Buchbinder, Ian Harris, Martin Underwood, Stacy Goergen, Chris G Maher
OBJECTIVES: To (1) estimate the proportion of patients seeking care for low back pain (LBP) who are imaged and (2) explore trends in the proportion of patients who received diagnostic imaging over time. We also examined the effect of study-level factors on estimates of imaging proportion. DATA SOURCES: Electronic searches of MEDLINE, Embase and CINAHL databases from January 1995 to December 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Observational designs and controlled trials that reported imaging for patients presenting to primary care or emergency care for LBP...
February 13, 2019: British Journal of Sports Medicine
Annu Navani, Laxmaiah Manchikanti, Sheri L Albers, Richard E Latchaw, Jaya Sanapati, Alan D Kaye, Sairam Atluri, Sheldon Jordan, Ashim Gupta, David Cedeno, Alejandro Vallejo, Bert Fellows, Nebojsa Nick Knezevic, Miguel Pappolla, Sudhir Diwan, Andrea M Trescot, Amol Soin, Adam M Kaye, Steve M Aydin, Aaron K Calodney, Kenneth D Candido, Sanjay Bakshi, Ramsin M Benyamin, Ricardo Vallejo, Art Watanabe, Douglas Beall, Todd P Stitik, Patrick M Foye, Erik M Helander, Joshua A Hirsch
BACKGROUND: Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or allogenic biologics. This field is rising like a Phoenix from the ashes of underperforming conventional therapy midst the hopes and high expectations of patients and medical personnel alike...
January 2019: Pain Physician
Kurt T Hegmann, Russell Travis, Roger M Belcourt, Ronald Donelson, Marjorie Eskay-Auerbach, Jill Galper, Scott Haldeman, Paul D Hooper, James E Lessenger, Tom Mayer, Kathryn L Mueller, Donald R Murphy, William G Tellin, Matthew S Thiese, Michael S Weiss
OBJECTIVE: Summarize evidence-based diagnostic guidelines for low back disorders. METHODS: A comprehensive literature review was conducted. A total of 101 articles of high or moderate quality addressing low back disorders diagnostic evaluation met the inclusion criteria. Evidence-based recommendations were developed and graded from (A) to (C) in favor and against the specific diagnostic test, with (A) level having the highest quality body of literature. Expert consensus was employed for insufficient evidence (I) to develop consensus guidance...
January 25, 2019: Journal of Occupational and Environmental Medicine
Sean P Riley, Brian T Swanson, Elizabeth Dyer
Objectives : The purpose of this systematic review was to determine if movement-based classification (MBC) systems are more effective than therapeutic exercise or guideline-based care (GBC) in improving outcomes in patients with low back pain (LBP) based upon randomized clinical trials (RCT) with moderate to high methodological quality and low to moderate risk of bias. Methods : The search strategy was developed by a librarian experienced in systematic review methodology and peer reviewed by a second research librarian...
February 2019: Journal of Manual & Manipulative Therapy
Cordelia Schott, Sonja Zirke, Jillian Marie Schmelzle, Christel Kaiser, Lluis Aguilar I Fernández
Back pain and diseases of the spine are today a health disorder of outstanding epidemiological, medical, and health economic importance. The cost of care for patients with lumbosciatic complaints are steadily increasing. Accordingly, the guidelines and treatments are constantly renewed. One concept is the orthotic care. In the following we want to give an overview of the literature and the effectiveness of lumbar orthoses in low back pain supplemented by our own data. A prospective randomized study with 230 patients, divided into three groups, each with two subgroups...
December 6, 2018: Orthopedic Reviews
Selaiman A Noori, Abdullah Rasheed, Rohit Aiyer, Boyoun Jung, Nitin Bansal, Ke-Vin Chang, Einar Ottestad, Amitabh Gulati
Background: Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient's desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBP and neck pain...
January 12, 2019: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Eivind Hasvik, Anne Julsrud Haugen, Stacey Haukeland-Parker, Stein Arne Rimehaug, Johannes Gjerstad, Lars Grøvle
STUDY DESIGN: A prospective observational study with translation and psychometric analyses of a questionnaire. OBJECTIVE: Cross-cultural adaptation of the Short-Form McGill Pain Questionnaire-2 into Norwegian. SUMMARY OF BACKGROUND DATA: The different versions of the McGill Pain Questionnaire (MPQ) have been important and influential tools for pain assessment. To more reliably assess qualities of both neuropathic and non-neuropathic pain, the Short-Form MPQ was revised in 2009 (SF-MPQ-2), including seven additional descriptors...
January 7, 2019: Spine
Marco Schreijenberg, Bart W Koes, Chung-Wei Christine Lin
Introduction Analgesic drugs are often prescribed to patients with non-specific low back pain (NSLBP). Recommendations for non-invasive pharmacological management of NSLBP from recent clinical practice guidelines were compared with each other and with the best available evidence on drug efficacy. Areas covered Recommendations concerning opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, antidepressants, anticonvulsants and muscle relaxants from national primary care guidelines published within the last 3 years were included in this review...
January 8, 2019: Expert Review of Clinical Pharmacology
Lisanne C Cruz, Hasanat A Alamgir, Parag Sheth, Ismail Nabeel
Context: Low back pain (LBP) is a common cause of disability in adults and primary care physicians (PCPs) are commonly the first medical practitioners to assess these patients. Despite this, PCPs often feel unprepared to make return to work (RTW) recommendations. Aims: The purpose of our project was to develop RTW guidelines for patients with LBP in the form of an accessible and adaptable electronic medical records (EMR) integrated tool. Settings and Design: All licensed physicians and physician extenders who see patients over the age of 18 years, presenting with acute LBP who are currently employed were eligible for participation...
November 2018: Journal of Family Medicine and Primary Care
Anshit Goyal, Mohamed Elminawy, Panagiotis Kerezoudis, Victor M Lu, Yagiz Yolcu, Mohammed Ali Alvi, Mohamad Bydon
The influence of obesity on spine surgery outcomes is highly controversial with a current clinical equipoise. Several studies suggest higher perioperative morbidity with obesity while other studies suggest otherwise. To address this gap in the literature, we conducted a systematic review and meta-analysis in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with the objective of better defining the impact of obesity on outcomes following lumbar spine surgery...
February 2019: Clinical Neurology and Neurosurgery
A Maggiani, A Abenavol
BACKGROUND: Low back pain is a heterogeneous condition, from which most patients recover after a few months. However, a considerable proportion of patients develop chronic pain despite different types of treatment. Primary care evidence-based guidelines for non-specific back pain highlight the importance of identifying indicators of poor prognosis in order for treatment to be appropriately targeted. The Start Back Screening Tool Questionnaire (SBST) is a prognostic tool developed and validated to identify subgroups of patients and guide the decision-making process for the initial primary care of the acute back pain...
January 2019: Annali di Igiene: Medicina Preventiva e di Comunità
David A Provenzano, Khalid M Kamal, Vincent Giannetti
BACKGROUND: The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surrounding the pain management practices of PCPs. OBJECTIVE: The purpose of this study is to assess the knowledge and practice of PCPs in management of chronic pain...
November 2018: Pain Physician
Jaya Sanapati, Laxmaiah Manchikanti, Sairam Atluri, Sheldon Jordan, Sheri L Albers, Miguel A Pappolla, Alan D Kaye, Kenneth D Candido, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Several cell-based therapies have been proposed in recent years the management of low back pain, including the injection of medicinal signaling cells or mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). However, there is only emerging clinical evidence to support their use at this time. OBJECTIVE: To assess the effectiveness of MSCs or PRP injections in the treatment of low back and lower extremity pain. STUDY DESIGN: A systematic review and metaanalysis of the effectiveness of PRP and MSCs injections in managing low back and lower extremity pain...
November 2018: Pain Physician
William Omar Contreras Lopez, Paula Alejandra Navarro, Marcos David Vargas, Eduardo Alape, Paul Anthony Camacho Lopez
OBJECTIVE: Compare pulsed radiofrequency treatment (PRF) with continuous radiofrequency treatment (CRF) to improve pain, functionality, and safety profile in patients with facet joint CLBP. METHODS: A systematic and critical review of recent literature was conducted in accordance with the PRISMA guidelines. The sources of the data were PubMed, Embase, Cochrane, Clinical Trials, and Lilacs. The MeSH terms were: "low back pain," "zygapophyseal joint" and "pulsed radiofrequency treatment...
November 4, 2018: World Neurosurgery
Shanthi Ramanathan, Peter Hibbert, Louise Wiles, Christopher G Maher, William Runciman
BACKGROUND: Although "non-specific" in 90% of cases, low back pain (LBP) is often treated as an independent entity, even though comorbidities are commonly associated with it. There is evidence that some LBP may be related to chronic conditions or be a symptom of poor health. The purpose of this study was to clarify the extent of comorbidities amongst a cohort of Australian adults with LBP and examine if having concurrent conditions has any association with appropriateness of care for LBP...
November 6, 2018: BMC Musculoskeletal Disorders
Timothy R Deer, Jay S Grider, Jason E Pope, Steven Falowski, Tim J Lamer, Aaron Calodney, David A Provenzano, Dawood Sayed, Eric Lee, Sayed E Wahezi, Chong Kim, Corey Hunter, Mayank Gupta, Rasmin Benyamin, Bohdan Chopko, Didier Demesmin, Sudhir Diwan, Christopher Gharibo, Leo Kapural, David Kloth, Brian D Klagges, Michael Harned, Tom Simopoulos, Tory McJunkin, Jonathan D Carlson, Richard W Rosenquist, Timothy R Lubenow, Nagy Mekhail
BACKGROUND: Lumbar spinal stenosis (LSS) can lead to compression of neural elements and manifest as low back and leg pain. LSS has traditionally been treated with a variety of conservative (pain medications, physical therapy, epidural spinal injections) and invasive (surgical decompression) options. Recently, several minimally invasive procedures have expanded the treatment options. METHODS: The Lumbar Spinal Stenosis Consensus Group convened to evaluate the peer-reviewed literature as the basis for making minimally invasive spine treatment (MIST) recommendations...
October 27, 2018: Pain Practice: the Official Journal of World Institute of Pain
Ulrike H Mitchell, Jennifer Hurrell
BACKGROUND: Between 2005 and 2015 significant changes in the clinical decision making paradigm for the treatment of spinal instability occurred. This was largely motivated by a clinical prediction rule (CPR) derivation study that was developed to specifically identify patients with low back pain who are more likely to respond positively to lumbar stabilization exercises. OBJECTIVE: This is a narrative literature review on the recent advances physiotherapy has made in the treatment of clinical spinal instability...
October 1, 2018: Journal of Back and Musculoskeletal Rehabilitation
Patricia C S Parreira, Christopher G Maher, Adrian C Traeger, Mark J Hancock, Aron Downie, Bart W Koes, Manuela L Ferreira
OBJECTIVES: (1) Describe the evolution of guideline-endorsed red flags for fracture in patients presenting with low back pain; (2) evaluate agreement between guidelines; and (3) evaluate the extent to which recommendations are accompanied by information on diagnostic accuracy of endorsed red flags. DESIGN: Systematic review. DATA SOURCES: MEDLINE and PubMed, PEDro, CINAHL and EMBASE electronic databases. We also searched in guideline databases, including the National Guideline Clearinghouse and Canadian Medical Association Infobase ...
October 18, 2018: British Journal of Sports Medicine
Fabio Martino Doniselli, Moreno Zanardo, Luigi Manfrè, Giacomo Davide Edoardo Papini, Alex Rovira, Francesco Sardanelli, Luca Maria Sconfienza, Estanislao Arana
PURPOSE: To assess the methodologic quality of guidelines for the management of low back pain (LBP) and compare their recommendations. METHODS: No ethics committee approval was needed for this systematic review. In March 2017, a systematic search was performed using MEDLINE, EMBASE, National Guideline Clearinghouse, and National Institute for Health and Clinical Excellence to find practice guidelines of assessment and management of LBP. The evaluation of guidelines quality was performed independently by four authors using the AGREE II tool, and the results were compared with previous appraisals performed in 2004 and 2009...
November 2018: European Spine Journal
Dinesh Rao, Gaelyn Scuderi, Chris Scuderi, Reetu Grewal, Sukhwinder Js Sandhu
Lower back pain (LBP) is one of the most common chief complaints encountered in primary care. Advanced imaging studies, including computerized tomography (CT) and magnetic resonance imaging (MRI), are frequently ordered in the setting of LBP. Structural abnormalities are commonly identified by CT and MRI in patients complaining of low back pain, however, these findings are also found in asymptomatic patients. In the past decade, multiple guidelines have been published to help providers identify patients in whom the use of advanced imaging is appropriate...
2018: Journal of Clinical Imaging Science
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