Physical conditioning programs for improving work outcomes among workers with back pain.

Physical conditioning programs for improving work outcomes among workers with back pain.
CONCLUSIONS: The effectiveness of physical conditioning programs in reducing sick leave for workers with back pain remains uncertain. For acute back pain, these programs probably have no effect; for subacute back pain, the effect is unclear, and for chronic back pain there is a small effect at one year follow-up that does not last in the long run. Remaining heterogeneity could not be explained by meta-regression. A better understanding of the mechanism behind physical conditioning programs and return to work is needed to develop more effective interventions. PMID: 20700550 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Work, Environment and Health)

Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain

Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain
Conclusions Long-term improvement was not better after instrumented transpedicular fusion compared with cognitive intervention and exercises. (Source: Annals of the Rheumatic Diseases)

A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain

A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain
The objective of this review was to determine the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP). Existing Cochrane reviews for the four interventions were screened for studies fulfilling the inclusion criteria. Then, the literature searches were updated. Only randomized controlled trials on adults (≥18 years) with chronic (≥12 weeks) non-specific LBP and evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work) were included. The GRADE approach was used to determine the quality of evidence. A total of 17 randomized controlled trials was include…

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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)

Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. BMJ 2010;340:c1035

Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. BMJ 2010;340:c1035
OBJECTIVE: To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. (Source: The Spine Journal)

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Cognitive behavioural treatment may work for low-back pain

Cognitive behavioural treatment may work for low-back pain
This study estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care.Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.References:Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, Volume 375, Issue 9718, Pages 916 - 923, 13 March 2010.Image source: Different regions (curvatures) of the vertebral column, Wikipedia, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images)

A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain
The objective of the present study is to determine the effectiveness of physical and rehabilitation interventions (i.e. exercise therapy, back school, transcutaneous electrical nerve stimulation (TENS), low level laser therapy, education, massage, behavioural treatment, traction, multidisciplinary treatment, lumbar supports, and heat/cold therapy) for chronic LBP. The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up to 22 December 2008. Existing Cochrane reviews for the individual interventions were screened for studies fulfilling the inclusion criteria. The search strategy outlined by the Cochrane Back Review Groups (CBRG) was followed. The following were included for selection criteria: (1) randomized controlled trials, (2) adult (≥18 years) pop…

Daily functioning and self-management in patients with chronic low back pain after an intensive cognitive behavioral programme for pain management

Daily functioning and self-management in patients with chronic low back pain after an intensive cognitive behavioral programme for pain management
Abstract  Chronic low back pain (CLBP) is associated with persistent or recurrent disability which results in high costs for society. Cognitive behavioral treatments produce clinically relevant benefits for patients with CLBP. Nevertheless, no clear evidence for the most appropriate intervention is yet available. The purpose of this study is to evaluate the mid-term effects of treatment in a cohort of patients with CLBP participating in an intensive pain management programme. The programme provided by RealHealth-Netherlands is based on cognitive behavioral principles and executed in collaboration with orthopedic surgeons. Main outcome parameters were daily functioning (Roland and Morris Disability Questionnaire and Oswestry Disability Questionnaire), self-efficacy (Pain Sel…

Low back pain in adolescent female rowers: a multi-dimensional intervention study

Low back pain in adolescent female rowers: a multi-dimensional intervention study
Abstract  The aim of this study was to determine whether a multi-dimensional intervention programme was effective in reducing the incidence of low back pain (LBP) and the associated levels of pain and disability in schoolgirl rowers. This non-randomised controlled trial involved an intervention (INT) group consisting of 90 schoolgirl rowers from one school and a control (CTRL) group consisting of 131 participants from three other schools. All participants in the INT group underwent a multi-dimensional programme that consisted of an individualised exercise programme based on an individual musculoskeletal screening (Week 1) and a LBP education session conducted by a physiotherapist (Week 2) and performed an off-water-conditioning programme conducted by a Physical Education te…

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Training in safer and healthier patient handling techniques.

Training in safer and healthier patient handling techniques.
Authors: Carta A, Parmigiani F, Roversi A, Rossato R, Milini C, Parrinello G, Apostoli P, Alessio L, Porru S The aim of the project was to educate nursing staff on patient handling techniques to prevent low back pain. Within the framework of a multidisciplinary preventive intervention, a pre-post study design was implemented in a hospital. One hundred and forty nurses and healthcare assistants attended a two-hour lesson and a three-hour practical training session; 48 nurses attended a train-the-trainer programme that was comprised of three-hour classes, two-hour lessons on communication techniques and four hours of practical training. Improvements were tested using questionnaires and direct observations. A statistically significant improvement was noted in questionnaire scores (p<0….

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