Low back pain

Wipf, Joyce E.; Deyo, Richard A.

doi:10.1016/s0025-7125(16)30065-7

Cited by 93 publications

(46 citation statements)

References 56 publications

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“…An estimated 25 to 50 million Americans experience chronic pain, with an annual direct economic effect of $24 billion [7][8][9], and veterans experience pain at rates exceeding those observed in the general public [10]. Approximately 50 percent of male veterans and up to 75 percent of female veterans treated in the Department of Veterans Affairs (VA) system may experience pain [11][12].…”

Section: Introductionmentioning

confidence: 99%

Complementary and alternative medicine use among veterans with chronic noncancer pain

Denneson

Corson

Dobscha³

2011

JRRD

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Abstract-We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users were compared with nonusers on demographic characteristics, pain-related clinical characteristics, disease burden, and treatment satisfaction. A majority of veterans (n = 327, 82%) reported prior use of at least one CAM modality, and nearly all (n = 399, 99%) were willing to try CAM treatment for pain. Chiropractic care was the least preferred option, whereas massage therapy was the most preferred (75% and 96%, respectively). CAM users were less likely to have service-connection disabilities (54% vs 68%; chi square = 4.64, p = 0.03) and reported having spent a larger percentage of their lives in pain (26% vs 20%; Z = 1.40, p = 0.04) than nonusers. We detected few differences between veterans who had tried CAM and those who had not, suggesting that CAM may have broad appeal among veterans with chronic pain. Implications for VA policy and practice and for clinicians treating veterans with chronic pain are discussed.Clinical Trial Registration: ClinicalTrials.gov. NCT00129480, "Improving the Treatment of Chronic Pain in Primary Care"; http://www.clinicaltrials.gov.

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Section: Introductionmentioning

confidence: 99%

Complementary and alternative medicine use among veterans with chronic noncancer pain

Denneson

Corson

Dobscha³

2011

JRRD

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“…The following are indications for a referral to either a neurosurgeon or orthopaedic spine surgeon: suspected spinal cord compression with myelopathy, intractable pain refractory to medications, cauda equina syndrome, and progressive or severe neurologic deficit [9]. The clinical red flags to be aware of are gait ataxia/upper motor neuron changes (myelopathy), bowel/ bladder dysfunction (cauda equina syndrome), night pain/weight loss (malignancy), and fevers/chills (infection).…”

Section: Surgical Managementmentioning

confidence: 99%

Lumbar Epidural Injections: Review of Efficacy and Discussion of Practice Options

2015

J Orth Rheumatol

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Background: In the United States, low back pain remains a common problem and a number one reason to see a physician in the outpatient setting. Etiology is complex and likely multifactorial and includes; degenerative disc disease, zygapophysial joint arthritis, vertebral misalignment, muscle strain, ligament sprain, myofascial pain, among others. Based on evidence of increased inflammatory response in disc herniation and degenerative discs, epidural steroid injections (ESI) have been used to treat lumbosacral radicular pain. Objective:To focus on the appropriate use of lumbar ESI in treating lumbosacral radicular pain in the United States, comparing and contrasting transforaminal, interlaminar, and caudal approaches for steroid delivery, as well as a comparison of commonly used steroid preparations.Methods: PubMED, MEDLINE, and OVID databases were reviewed utilizing the following subject headings: low back pain, epidural steroid injections, transforaminal epidural steroid injections (TFESI), interlaminar epidural steroid injections (ILESI), and caudal epidural steroid injections (CESI) dated from 2000 to 2014. The bibliographies of major articles and reviews were also cross-referenced for additional sources.Results: A number of articles that included randomized control trials, comprehensive and systematic reviews, and meta-analyses were found. These provided a broad, detailed overview of the subject, that we used to explore the data surrounding use of ESI for treatment of lumbosacral radicular pain. Conclusions:Most agree that the evidence for epidural steroid injection efficacy is strongest for short term relief of lumbosacral radicular pain. Most of the systemic reviews have agreed that the strongest evidence for TFESI use is for relief of unilateral lumbosacral radicular pain. The evidence suggests using ILESI in patients with bilateral and/ or multi-level lumbosacral radicular pain. The data correlates efficacy of CESI in low level bilateral or multilevel lumbosacral radicular pain as well as in patients with history of lumbar surgery. Introduction EpidemiologyIn the United States, low back pain remains common. Approximately two-thirds of the population has low back pain at some time in their lives and approximately 26% of adults surveyed admit to having low back pain within the last three months [1]. Back pain is the fifth most common reason for all physician visits [2] and the second most common symptom-related reason for clinician visits [3,4]. The 2010 Global Burden of Disease (GBD) results showed that there is a very high prevalence and burden from low back pain throughout the world [5]. Low back pain was found to have the sixth highest burden of the 291 conditions studied, and caused more disability than any other condition. It is well known that back pain accounts for a large proportion of health care expenditures and that these expenditures have been increasing substantially [6]. In fact, these expenditures have been increasing more rapidly than overall health expenditures [6]. Taken together ...

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“…Specific low back pain is related to specific pathologies and can be diagnosed early through warning signs (Neoplasm, Infectious,vascular,metabolic,or endocrine related) (Wipf & Deyo RA, 1995).…”

Section: Concept and Typesmentioning

confidence: 99%

The Treatment of Low Back Pain and Scientific Evidence

Marqués¹

2012

Low Back Pain

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Low back pain

Cited by 93 publications

References 56 publications

Complementary and alternative medicine use among veterans with chronic noncancer pain

Complementary and alternative medicine use among veterans with chronic noncancer pain

Lumbar Epidural Injections: Review of Efficacy and Discussion of Practice Options

The Treatment of Low Back Pain and Scientific Evidence

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