Struck From Behind: Maintaining Quality of Life With Chronic Low Back Pain

Struck From Behind: Maintaining Quality of Life With Chronic Low Back Pain
A 38-year-old woman was the driver of a stopped car that was struck from behind by another vehicle. She developed sudden flexion and extension of her back, but without head trauma or change in level of consciousness. On the evening of the accident, she presented to the emergency room with severe mid and low back pain, and right knee pain, but was discharged with pain medications. One week following the accident, the pain became increasingly severe. For the past 6 months, she has been unable to work and is on disability. Chiropractic treatment, trigger-point injections, epidural injections and physical therapy, nonsteroidal anti–inflammatory drugs, muscle relaxers, and hydrocodone provided no or minimal relief. An MRI of the thoracic spine revealed a subacute appearing left paracentral di…

Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases.

Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases.
Authors: H’ng MW, Wanigasiri UI, Ong CL Perineural (Tarlov) cysts are usually incidental findings during magnetic resonance imaging (MRI) performed for low back pain. However, in a tertiary women’s hospital, they may present as incidental findings on gynecological ultrasound imaging. Approximately 40 000 pelvic scans are performed annually in our department. Tarlov cysts were identified in three women between August 2007 and September 2008. In two patients (Cases 1 and 3), these cysts were initially misdiagnosed as hydrosalpinges on ultrasound examination, the latter having a differential diagnosis of an ovarian cyst. Two patients (Cases 1 and 2) were symptomatic, although Case 2 had symptoms that could not entirely be accounted for by the location of the cyst. Although asymptomatic, C…

Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report

Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report
Conclusions: Conservative management is considered to be the standard of care for spondylolysis and should be explored in its various forms for symptomatic low back pain patients who present without neurologic deficits and with spondylolisthesis below grade III. The response to treatment for the veteran patient in this case suggests that lumbar flexion/distraction may serve as a safe and effective component of conservative management of mechanical low back pain for some patients with spondylolysis and spondylolisthesis. (Source: Journal of Chiropractic Medicine)

CT-guided sacroplasty for the treatment of zone II sacral insufficiency fractures

CT-guided sacroplasty for the treatment of zone II sacral insufficiency fractures
Sacral insufficiency fractures are a relatively common cause of low back pain in the elderly. Osteoporosis is the leading cause, most commonly affecting elderly women. Other causes include chronic steroid use, radiation exposure, and arthritis. Patients typically present with severe low back pain, which in some cases results in immobility with its associated complications. However, sacral insufficiency fractures are commonly underdiagnosed due to difficulty in visualizing the fracture line on radiographs. However, other imaging methods, such as computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy, can accurately diagnose this condition. (Source: Clinical Radiology)

Back Inversion Table - How Using a Back Inversion Table Can Help Relieve Back Pain

Back Inversion Table - How Using a Back Inversion Table Can Help Relieve Back Pain
Using a back inversion table is one example of the many ways in which spinal traction (stretching the spine) has been used in an attempt to relieve back pain. Today, inversion therapy is no longer called an alternative treatment because it has been the subject of a great deal of clinical study.

Mesoblast Limited (ASX:MSB) Proprietary Stem Cells Successfully Repair/Regenerate Damaged Intervertebral Disc Cartilage

Mesoblast Limited (ASX:MSB) Proprietary Stem Cells Successfully Repair/Regenerate Damaged Intervertebral Disc Cartilage
Australia’s regenerative medicine company, Mesoblast Limited (ASX:MSB)(PINK:MBLTY), today announced highly successful preclinical trial results of its adult stem cells in the treatment of degenerative intervertebral disc disease, the leading cause of low back pain. (Source: Neurology / Neuroscience News From Medical News Today)

Do psychological characteristics predict response to exercise and advice for subacute low back pain?

Do psychological characteristics predict response to exercise and advice for subacute low back pain?
To determine whether psychological characteristics predict outcome and/or response to physiotherapist-directed exercise- or advice-based treatment of subacute low back pain.We conducted a secondary analysis of a factorial, placebo-controlled trial (n = 259). The psychological characteristics were catastrophizing, coping, pain self-efficacy, fear of injury/movement, depression, anxiety, and stress. We used mixed models to predict pain and function outcomes (both scored on a 0-10 scale). The models include a term for treatment group, a term for the psychological characteristic (which tested prediction of outcome), and an interaction term between the treatment group and psychological characteristic (which tested treatment effect modification). To aid the interpretation of the magnitude of the…

Dyspnea and Multiple Pulmonary Nodules

Dyspnea and Multiple Pulmonary Nodules
Dr. Adam Levine: Today’s case is that of a 67-year-old man, a retired physician of Indian origin, who was referred to the emergency department (ED) by his primary care physician for a 2-day history of increasing shortness of breath and an outpatient computed tomography (CT) scan that showed multiple pulmonary nodules. The patient stated that he was well until 2 months previously, when he acutely developed lower back pain. His primary care physician ordered magnetic resonance imaging (MRI) of the lumbar spine, which showed L2/3 spinal stenosis. The patient subsequently received steroid injections on two occasions. Of note, he reported receiving significant dental work during the same time period. A week after the spinal injections, the patient developed a low grade fever and night sweats. H…

The predictive effect of fear-avoidance beliefs on low back pain among newly qualified health care workers with and without previous low back pain: a prospective cohort study

The predictive effect of fear-avoidance beliefs on low back pain among newly qualified health care workers with and without previous low back pain: a prospective cohort study
Conclusion: Both physical work load and fear-avoidance beliefs matters in those with previous LBP. Only fear-avoidance beliefs matters in those without previous LBP. The study did not find a moderating effect of fear-avoidance beliefs on the association between physical work load and LBP. (Source: BMC Musculoskeletal Disorders)

[Interdisciplinary treatment : Long-lasting, effective, and cost-effective.]

[Interdisciplinary treatment : Long-lasting, effective, and cost-effective.]
Authors: Nagel B, Korb J The efficacy of intensive interdisciplinary pain management programs for patients with chronic low back pain has been repeatedly demonstrated. A controversial issue in previous studies is the cost-effectiveness of this treatment. Between 2001 and 2006, a total of 575 patients with chronic nonspecific back pain took part in an outpatient pain management program at the German Red Cross Pain Center (DRK Schmerz-Zentrum Mainz) in Mainz, Germany. Complete follow-up data were available for 351 patients 1 year after the end of treatment and were included in the study. No differences between these patients and the dropouts were found. Pain, impairment, and mental well-being had significantly improved after 1 year. For employed patients, the number of absent days decrea…

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