Deconditioning in chronic low back pain: might there be a relationship between fitness and magnetic resonance imaging findings?

Deconditioning in chronic low back pain: might there be a relationship between fitness and magnetic resonance imaging findings?
Abstract  The presence of persistent low back pain leads to avoidance of daily activities, contributes to further exercise intolerance and subsequent further loss of functional capacity. We sought to search for the relationship between lumbar magnetic resonance imaging findings and deconditioning in a homogeneous subset of patients with low back pain. We studied 20 sedentary, nonsmoking patients with chronic low back pain using symptom-limited cardiopulmonary exercise testing using treadmill breath-by-breath analysis using modified Bruce protocol. Lumbar facet and disc degeneration involving L1-S1 levels were assessed using 1.5 Tesla MRI. The total number of levels involved was positively correlated with age (r = 0.478, P = 0.033). The Pfirrmann grading o…

Exercises That Strengthen the Lower Back and Prevent Back Pain

Exercises That Strengthen the Lower Back and Prevent Back Pain
The issue of lower back strengthening workout is a very important part of any kind of workout program. This can be done by doing the basic workouts that play a part in strengthening your back, and once this starts to get very easy you can then introduce intermediate back exercises to your personal program. The strengthening of the various core muscles like the lower back, abdominal and hip flexors and also which play a very vital role in stabilizing the spine, the pelvis and shoulders and also minimizes or totally stops back pain.

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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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Is one question enough to screen for depression?

Is one question enough to screen for depression?
Conclusions: The depression-question from SHC identified most of the depressed patients measured by HSCL-25 in low back pain patients, whiplash patients, and disability pensioners, and can therefore be considered an indicator of depression. Satisfactory sensitivity and specificity were detected, as well as similar responsiveness as determined by the ROC analyses. The results indicate that one simple question could replace a whole questionnaire (HSCL-25) in identifying depressive patients. PMID: 20603250 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Public Health)

Bilateral insufficiency fracture of the femoral head and neck in a case of oncogenic osteomalacia.

Bilateral insufficiency fracture of the femoral head and neck in a case of oncogenic osteomalacia.
We describe a case of oncogenic osteomalacia in an adult male who presented with low back pain and bilateral hip pain. Extensive investigations had failed to find a cause. A plain pelvic radiograph showed Looser’s zones in both femoral necks. MRI confirmed the presence of insufficiency fractures bilaterally in the femoral head and neck. Biochemical investigations confirmed osteomalacia which was unresponsive to treatment with vitamin D and calcium. A persistently low serum phosphate level suggested a diagnosis of hypophosphataemic osteomalacia. The level of fibroblast growth factor-23 was highly raised, indicating the cause as oncogenic osteomalacia. This was confirmed on positron-emission tomography, MRI and excision of a benign fibrous histiocytoma following a rapid recovery. The diagnos…

Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses

Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses
While psychosocial factors have been associated with musculoskeletal symptoms among nurses in some countries, previous studies of Iranian nurses show little association using a demand and control questionnaire. The aim of this study is to assess and evaluate the prevalence of musculoskeletal symptoms and to assess their relationships with psychosocial factors among nurses in Iran.In a cross-sectional study, 347 hospital nurses completed a self-reported questionnaire containing the Standardized Nordic questionnaire for musculoskeletal symptoms and the General Nordic questionnaire for Psychological and Social factors at work (QPS Nordic 34+ Questionnaire).Prevalence of low back pain, knee pain, shoulder pain, and neck pain were 73.2%, 68.7%, 48.6%, and 46.3%, respectively. Middle and high st…

Directed attention alters the temporal activation patterns of back extensors during trunk flexion–extension in individuals with chronic low back pain

Directed attention alters the temporal activation patterns of back extensors during trunk flexion–extension in individuals with chronic low back pain
Abstract  In chronic low back pain patients (CLBP), neuromuscular and pain intensity have been identified as contributing factors in the disability of the individual. However, it is unclear whether pain intensity influences neuromuscular activation and if directed attention mediates this relationship. Thus, the purpose of this study was to determine the effect of directed attention in individuals with different pain intensities on back extensor activation profiles. Fifty-four CLBP patients were separated into either high- or low-pain groups. Surface electromyograms were recorded from back muscles while the subjects performed a trunk flexion motion for four different attention conditions. Pattern recognition and repeated measures ANOVAs were used to examine the effect of sex…

Causal assessment of occupational lifting and low back pain: results of a systematic review

Causal assessment of occupational lifting and low back pain: results of a systematic review
Conclusions: This review uncovered several high-quality studies examining a relationship between occupational lifting and LBP, but these studies did not consistently support any of the Bradford-Hill criteria for causality. There was moderate evidence of an association for specific types of lifting and LBP. Based on these results, it is unlikely that occupational lifting is independently causative of LBP in the populations of workers studied. Further research in specific subcategories of lifting would further clarify the presence or absence of a causal relationship. (Source: The Spine Journal)

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain
Background: Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP. Methods: A total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n=100), LBP without ITB tightness (n=100) and no LBP (n=100). Hip abductor muscle strength was measured in all subjects. Results: Analysis of Covariance (ANCOVA) with the…

Chronic axial compression of the mouse tail segment induces MRI bone marrow edema changes that correlate with increased marrow vasculature and cellularity

bra target=_blank rel=nofollow href=http://www.medworm.com/index.php?rid=3304586cid=c_1_31_ffid=33779url=http://dx.doi.org/10.1002%2Fjor.21103 Chronic axial compression of the mouse tail segment induces MRI bone marrow edema changes that correlate with increased marrow vasculature and cellularity /abrMagnetic resonance imaging (MRI) of bone marrow edema (BME) has been found to be helpful in the diagnosis of back pain attributed to degenerative disk disease (DDD) and spondyloarthropathy (SA), but its interpretation is limited by a lack of knowledge of its nature and natural history. We assessed effects of compressive forces to mouse tail segments of WT and TNF-Tg mice with SA, via contrast enhanced-MRI and histology. Normalized marrow contrast enhancement (NMCE) of uninstrumented WT vertebrae significantly decrease, threefold (p 0.01) from 8 to 12 weeks of age, while the NMCE of TNF-Tg vertebrae remained elevated. Compressive loading (6× body weight) increased NMCE twofold (p 0.02) within 2 weeks in WT tails, which was equal to 6× loaded TNF-Tg tails within 4 weeks. Histology conf… br

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