Trends in diagnosis of painful neck and back conditions, 2002 to 2011

Sinnott, Patricia L.; Dally, S; Trafton, Jodie A.; Goulet, Joseph L.; Wagner, Todd H.

doi:10.1097/md.0000000000006691

Cited by 26 publications

(16 citation statements)

References 49 publications

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“…US military Veterans are substantially more likely than non‐Veterans to report LBP 2 and to report severe levels of pain 3 . The annual prevalence of health care visits for LBP among Veterans is steadily increasing at a rate of more than 4% each year 4 . LBP is the single most common pain site among Veterans 5 and is associated with substantial functional limitations 6 and lower quality of life 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Predicting Persistent Disabling Low Back Pain in Veterans Affairs Primary Care Using the STarT Back Tool

Kneeman

Battalio

Korpak

et al. 2020

PM&R

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Background The Subgrouping for Targeted Treatment (STarT Back) is a stratified care approach to low back pain (LBP) treatment. The predictive validity of STarT Back in Veterans Affairs (VA) primary care has not been demonstrated. Objective To examine the validity of the STarT Back tool for predicting future persistent disabling LBP in VA primary care. Design Cohort study. Setting VA primary care in Washington State. Participants Veterans seeking care for LBP in VA primary care clinics. Interventions Not applicable. Main Outcome Measures The STarT Back tool was used to classify Veterans according to their baseline risk group (low vs medium vs high). The primary study outcome, persistent disabling LBP, was defined as a Roland‐Morris Disability Questionnaire (RMDQ) score ≥ 7 at 6‐month follow‐up. Analyses examined discrimination and calibration of the baseline STarT Back risk groups for prediction of persistent disabling LBP at 6‐month follow‐up. Results Of the study sample, 9% were female and 80% reported longstanding LBP (>5 year duration). Among 538 participants, the baseline STarT Back risk groups were associated with future persistent disabling LBP at 6‐month follow‐up. Within each baseline STarT Back risk group, the proportions with future persistent disabling LBP at 6‐month follow‐up were 54% (low risk), 88% (medium risk), and 97% (high risk). The baseline STarT Back risk groups had useful discrimination (area under the curve [AUC] 0.79) for predicting future persistent disabling LBP, but the proportion of Veterans with persistent disabling LBP at 6‐month follow‐up was substantially higher than that observed in non‐VA primary care settings. Conclusions The STarT Back risk groups had useful discrimination (AUC = 0.79) for future persistent disabling LBP, but calibration was poor, underestimating the risk of persistent disabling LBP. The STarT Back tool may require updating for use in VA primary care.

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Section: Introductionmentioning

confidence: 99%

Predicting Persistent Disabling Low Back Pain in Veterans Affairs Primary Care Using the STarT Back Tool

Kneeman

Battalio

Korpak

et al. 2020

PM&R

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“…Epidural steroid injections (ESIs) are a commonly used intervention for the treatment of refractory radicular spinal pain. [1][2][3] In appropriately selected patients, ESIs can provide pain reduction, improve function, and may have a surgical sparing effect. [4][5][6] Despite numerous studies evaluating the effectiveness of ESIs, no evidence-based guidelines addressing appropriate therapeutic dosing for ESIs have been established.…”

Section: Introductionmentioning

confidence: 99%

Current Trends in Steroid Dose Choice and Frequency of Administration of Epidural Steroid Injections: A Survey Study

Vydra¹,

McCormick

Clements³

et al. 2019

PM&R

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Background: Epidural steroid injections (ESI) are commonly used to treat refractory radicular spinal pain. Although evidence suggests that an increasing cumulative dose of exogenous corticosteroid may be harmful, knowledge of current practice patterns is limited regarding the choice of dose and frequency of epidural steroid injections (ESIs). Objective: Describe current practice trends in the dose selection and frequency of administration of transforaminal ESIs (TFESIs) and interlaminar ESIs (ILESIs). Design: Cross-sectional survey study. Setting: Not applicable. Participants: Three hundred fourteen physician members of the Spine Intervention Society (SIS). From May to June 2018, an online survey was distributed to 5907 physician members of the SIS. Interventions: Not applicable. Main Outcome Measures: Corticosteroid dose used by practitioners and the number of annual ESIs administered per patient. Results: Three hundred fourteen physicians responded to the survey. For single cervical or lumbar injections of dexamethasone, most physicians (56.0%) reported using 10 mg; 17% of physicians reported use of doses greater than 10 mg, with 6% using a dose of 20 mg per injection level. The most common particulate corticosteroid dose used during both cervical and lumbar ILESIs was 80 mg (cervical = 55.4%, lumbar = 54.7%). During cervical and lumbar ILESIs, 17% and 12.7% of physicians reported using doses greater than 80 mg, respectively. Almost 10% of physicians reported performing cervical TFESIs with particulate steroids. Forty percent of physicians reported allowing four ESIs at a given spinal segmental level per year (cervical/thoracic/lumbosacral). A small percentage of physicians reported allowing more than six ESIs annually (6%) and >10 injections annually (1%). Conclusions: There is considerable variability among this large cohort of interventionists with regard to corticosteroid dose selection and epidural steroid injection frequency. A small proportion of respondents reported Mulitsociety Pain Workgroup guideline-discordant use of particulate steroids during cervical TFESIs. These findings demonstrate a need for additional research regarding both the reasons for such variation in care and the reasons for guideline-discordant practice in a subset of physicians. Level of Evidence: IV.

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“…Due to its high incidence and the expansion of the age of the affected population -if in the past it was a symptom associated especially with old people, nowadays it is spread among young people and even children -, the CCP becomes a topical subject in the scientific researches in different fields. 1 All these have as goal the development of some effective preventive and therapy methods, based especially on the accurate identification of the causes and an exact understanding of the implied pathological mechanisms.…”

Section: Introductionmentioning

confidence: 99%

The benefits of the C1 and C2 vertebrae derotation in a patient with chronic cervical myofascial pain

Marius-Sorin¹,

Debucean²,

Manuela³

2017

PONS

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The benefits of the C1 and C2 vertebrae derotation in a patient with chronic cervical myofascial pain. ABSTRACTObjective. The aim of this study was to present the case of a patient with chronic cervical pain and an elevated postural imbalance in the frontal plane.Method. The present case report was carried out in June 2017. The subjective assessment of the pain, the global postural assessment, the computerized baropodometry, the assessment of the walking and the biomechanics of the foot and functional tests (Fukuda, Romberg, VAD 2.7, Vasyli Medical and Sahrmann), were used to assess the postural imbalance.Results. The objective results were the immediate alignment of the cranium and underjaw to the central line of the body, a partial cancellation of the compensatory pathological curves from the area of the dorsal lumbar spine and the amplification of the laterality movement. The subjective result, as reported by the patient, was the absence of the previously felt discomfort at the active cranio-cervical mobility test, in the left laterality movement.Conclusion. The manual derotation of the C1 and C2 vertebrae resulted in efficient and long-term postural rehabilitation by canceling the fascial constraints and asymmetries at the base of the skull that maintained the postural syndrome, responsible in time for the onset of the symptomatology.

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Trends in diagnosis of painful neck and back conditions, 2002 to 2011

Cited by 26 publications

References 49 publications

Predicting Persistent Disabling Low Back Pain in Veterans Affairs Primary Care Using the STarT Back Tool

Predicting Persistent Disabling Low Back Pain in Veterans Affairs Primary Care Using the STarT Back Tool

Current Trends in Steroid Dose Choice and Frequency of Administration of Epidural Steroid Injections: A Survey Study

The benefits of the C1 and C2 vertebrae derotation in a patient with chronic cervical myofascial pain

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