Back Pain and Sciatica: Controlled Trials of Manipulation, Traction, Sclerosant and Epidural Injections

Mathews, John; Mills, S. B.; Jenkins, V.; Grimes, Sandra; Morkel, M.; Mathews, W. Christopher; Scott, Ciera; Sittampalam, Y

doi:10.1093/rheumatology/26.6.416

Cited by 234 publications

(131 citation statements)

References 0 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…This finding agrees to the current literature review result [28,38]. The randomized control trial with relatively acceptable method score [38], included subjects with neurological deficit involvement did not support to use mechanical lumbar traction for LBP management.…”

Section: Discussionsupporting

confidence: 89%

“…There is no randomized control trial has acceptable method score with exclusive criteria of subjects having neurological deficit. Only one study with minimal method score supported the use of mechanical lumbar traction for management of LBP patients without neurological deficits [28]. Yet, majority of literatures published in peer review journals did not specify the detail of the neurological deficit and radicular leg pain in their inclusive criteria.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction

2009

View full text Add to dashboard Cite

The objective of the study was to develop a clinical prediction rule for identifying patients with low back pain, who improved with mechanical lumbar traction. A prospective, cohort study was conducted in a physiotherapy clinic at a local hospital. Patients with low back pain, referred to physiotherapy were included in the study. The intervention was a standardized mechanical lumbar traction program, which comprised three sessions provided within 9 days. Patient demographic information, standard physical examination, numeric pain scale, fear-avoidance beliefs questionnaire and Oswestry low back pain disability index (pre-and post-intervention) were recorded. A total of 129 patients participated in the study and 25 had positive response to the mechanical lumbar traction. A clinical prediction rule with four variables (non-involvement of manual work, low level fear-avoidance beliefs, no neurological deficit and age above 30 years) was identified. The presence of all four variables (positive likelihood ratio = 9.36) increased the probability of response rate with mechanical lumbar traction from 19.4 to 69.2%. It appears that patients with low back pain who were likely to respond to mechanical lumbar traction may be identified.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction

2009

View full text Add to dashboard Cite

show abstract

“…The results of this review are shown in Table 2. Four of the six included trials [12,14,33,50] are in fact a comparison of ESIs with a control. The study by Dashfield [25] compared steroid epidurals to targeted steroid placement during spinal endoscopy.…”

Section: Resultsmentioning

confidence: 99%

Epidural steroid injections in the management of low-back pain with radiculopathy: an update of their efficacy and safety

2011

View full text Add to dashboard Cite

Introduction Epidural steroid injections (ESIs) have been widely used for over 50 years in the treatment of low-back pain with radiculopathy. Most interventional pain physicians strongly believe in their efficacy and safety. Recent Cochrane systematic reviews have disclosed controversial results and have questioned the effectiveness of ESIs. Moreover, a few neurological adverse events have been reported recently. Methods A literature search of systematic reviews analysing the effectiveness and complications of ESIs was carried out. The scientific quality of the reviews was assessed using the validated index of Oxman and Guyatt. We relied on data abstraction and quality ratings of the placebo-controlled trials as reported by high-quality systematic reviews. Results Two types of systematic reviews were found. The Cochrane high-quality systematic reviews combining the three approaches and different pathologies were predominantly non-conclusive. The second type of review, emanating from the US Evidence-based Practice Centers, distinguishing between the routes of administration and between the principal pathologies found a moderate shortterm benefit of ESIs versus placebo in patients with disc herniation and radiculitis, in keeping with the clinical experience. ESIs are generally well tolerated and most complications are related to technical problems. Cases of paraplegia, complicating the foraminal route and related to the violation of a radiculomedullary artery, have been recently reported. They are predominantly observed in previously operated patients. Conclusions Epidural steroid injections have a moderate short-term effect in the management of low-back pain with radiculopathy. Severe neurological complications are exceptional, but call for research for alternative approaches to the foramen as well as for means to detect an eventual arterial injury.

show abstract

“…The Cochrane review included six pragmatic trials that reported on short-term pain relief [8,22,38,63,77,78]. Four of these six trials showed a non-significant positive effect of corticosteroids compared to other procedures.…”

Section: Epidural Injections Vs Other Interventionsmentioning

confidence: 99%

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

et al. 2005

View full text Add to dashboard Cite

Back Pain and Sciatica: Controlled Trials of Manipulation, Traction, Sclerosant and Epidural Injections

Cited by 234 publications

References 0 publications

A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction

A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction

Epidural steroid injections in the management of low-back pain with radiculopathy: an update of their efficacy and safety

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

Contact Info

Product

Resources

About