Diagnostic Nerve Blocks Costly — And Controversial (CME/CE)

Diagnostic Nerve Blocks Costly — And Controversial (CME/CE)
While some guidelines recommend two diagnostic nerve blocks before radiofrequency treatment for chronic low back pain, a randomized trial showed greater success without use of the prior blocks. (Source: MedPage Today State Required CME)

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Back-pain guidelines may delay treatment

Back-pain guidelines may delay treatment
BALTIMORE, July 28 (UPI) — Skipping long-held diagnostic guidelines may speed up pain relief for some with back pain, U.S. researchers say. Pain management - United States - Health - Medicine - Medical Specialties (Source: Health News - UPI.com)

Physiotherapists’ telephone consultations regarding back pain: A method to analyze screening of risk factors.

Physiotherapists’ telephone consultations regarding back pain: A method to analyze screening of risk factors.
Conclusions: The method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations. PMID: 20649497 [PubMed - as supplied by publisher] (Source: Physiotherapy Theory and Practice)

Doubt Cast on Common Back Pain Management

Doubt Cast on Common Back Pain Management
Many people with arthritis-related back pain might be prevented from getting long-lasting pain relief under the current management guidelines, US researchers said Friday.Source: Reuters Health Related MedlinePlus Pages: Arthritis, Back Pain (Source: MedlinePlus Health News)

12. Pain Originating from the Lumbar Facet Joints

12. Pain Originating from the Lumbar Facet Joints
Although the existence of a “facet syndrome” had long been questioned, it is now generally accepted as a clinical entity. Depending on the diagnostic criteria, the zygapophysial joints account for between 5% and 15% of cases of chronic, axial low back pain. Most commonly, facetogenic pain is the result of repetitive stress and/or cumulative low-level trauma, leading to inflammation and stretching of the joint capsule. The most frequent complaint is axial low back pain with referred pain perceived in the flank, hip, and thigh. No physical examination findings are pathognomonic for diagnosis. The strongest indicator for lumbar facet pain is pain reduction after anesthetic blocks of the rami mediales (medial branches) of the rami dorsales that innervate the facet joints. Because false-positiv…

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Recent low back pain guidelines offer similar advice

Recent low back pain guidelines offer similar advice
Recent clinical practice guidelines offer similar recommendations for assessing and managing low back pain, and clinicians can improve patient care by adopting these recommendations, according to a review published in the June issue of The Spine Journal, reported HealthDay News. (Source: Drug Topics - Top News)

“We Need to Get You Focused”: General Practitioners’ Representations of Chronic Low Back Pain Patients

“We Need to Get You Focused”: General Practitioners’ Representations of Chronic Low Back Pain Patients
Although subject to considerable research from perspectives including general practitioners, patients, and perspective guidelines, chronic low back pain (CLBP) continues to be a common but contentious condition in primary care. We used medical consultation records, critical incident interviews, and a think-aloud problem-solving task to examine how general practitioners applied professional knowledge of the condition, especially in relation to psychosocial care. Using qualitative content analysis and thematic analysis, we identified a pragmatic, goal-focused approach to patients, a schema based on biomedical knowledge and tacit theories of motivation. The doctors’ expectations for CLBP included uncertainty over symptoms and doubts over patient credibility, which helped to explain an a…

Improving the coordination of care for low back pain patients by creating better links between acute and community services.

Improving the coordination of care for low back pain patients by creating better links between acute and community services.
Authors: Staiger PK, Serlachius A, Macfarlane S, Anderson S, Chan T, Young G This paper reports on the development of a care-pathway to improve service linkages between the acute setting and community health services in the treatment of low back pain. The pathway was informed by two processes: (1) a literature review based on best-practice guidelines in the assessment, treatment and continuity of care for low back pain patients; and (2) consultation with staff and key stakeholders. Stakeholders from both the acute and community sectors comprised the Working Group, who identified central areas of concern to be addressed in the care-pathway, with the goal of preventing chronicity of low back pain and reducing emergency department presentations. The main outcomes achieved include: the dev…

Herbal medicine for low back pain

Herbal medicine for low back pain
Source: Cochrane Library Area: Evidence > Complementary Medicine Abstract:   Background Low-back pain is a common condition and a substantial economic burden in industrialized societies. A large proportion of patients with chronic low-back pain use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in low-back pain.   Objectives To determine the effectiveness of herbal medicine for non-specific low-back pain.   Search strategy We searched the following electronic databases: Cochrane Complementary Medicine Field Trials Register (Issue 3, 2005), MEDLINE (1966 to July 2005), EMBASE (1980 to July 2005); checked reference lists in review articles, guidelines and retrieved trials; and…

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The Staffordshire Arthritis, Musculoskeletal, and Back Assessment (SAMBA) Study: a prospective observational study of patient outcome following referral to a primary-secondary care musculoskeletal interface service

The Staffordshire Arthritis, Musculoskeletal, and Back Assessment (SAMBA) Study: a prospective observational study of patient outcome following referral to a primary-secondary care musculoskeletal interface service
We describe the protocol for a twelve-month prospective observational study which aims to describe the outcome of patients referred to musculoskeletal and back pain services at the primary-secondary care interface and to develop simple prognostic measures to guide clinical prioritisation and triage. Methods: All patients referred over a twelve-month period from primary care to musculoskeletal and back pain clinics in the primary-secondary care interface Clinical Assessment and Treatment Service in North Staffordshire will be mailed a postal questionnaire prior to their consultation. This will collect information on quality of life, general health, anxiety and depression, pain, healthcare utilisation including medication use, occupational characteristics, and socio-demographics. At the cons…

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