Spinal radiographs in those with back pain —when are they appropriate to diagnose vertebral fractures?

AbstractThe presence of an osteoporotic vertebral fracture improves fracture risk assessment and may change management, so it is vital for healthcare professionals to assess patients for the presence or absence of these fractures. This may be particularly important in the presence of back pain. However, the correlation between low back symptoms and spinal imaging results is poor and the pathophysiology of most low back pain is not known, leading to a common conclusion that spinal radiographs are not appropriate for the assessment of back pain. For individual patients with back pain, spinal radiographs should be considered if they have certain features in the history and examination. As well as the traditional risk factors for osteoporosis, self-reported descriptives of back pain and novel physical examination findings have been shown to make the presence of vertebral fractures more likely. Systematic approaches have the potential to improve bone health across the population but need to be targeted to be cost-effective. Spinal radiographs should be considered for individual older patients with back pain if they have certain additional features in the history and examination.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research

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Conclusions: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion.IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving importan...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
ConclusionPVM decrease was significantly related to LBP and delayed union after osteoporotic vertebral fracture onset. ADL decline at the 3-month follow-up was a risk factor for PVM decrease. Therefore, restoring ADLs within 3  months after onset is important.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
(The North American Menopause Society (NAMS)) Lumbar disc degeneration and resulting lower back pain become greater concerns with age and disproportionately affect women more than men, likely as a result of decreasing estrogen levels during menopause. A new study demonstrates that vitamin D deficiency, smoking, high body mass index (BMI), and osteoporosis are risk factors for greater back pain. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Abstract Physicians often overlook exercise as a treatment or prophylactic measure for many common diseases and ailments. It can be used to treat comorbidities including obesity, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, osteoporosis, osteoarthritis, cancer, and low back pain. Education on the general physical activity guidelines as well as easy exercise prescription methods can improve the ability of physicians to prescribe exercise as a therapeutic option. In addition, identifying barriers to compliance with exercise and ways to overcome these barriers is also necessary in...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
ConclusionThis study showed that manual therapy with pain specific education is an effective tool to improve QoL in patients with CLBP by reducing pain in the short term. Therefore, combining manual therapy with neuroscience pain education can be a promising option to increase QoL in patients with CLBP.
Source: European Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
Physicians often overlook exercise as a treatment or prophylactic measure for many common diseases and ailments. It can be used to treat comorbidities including obesity, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, osteoporosis, osteoarthritis, cancer, and low back pain. Education on the general physical activity guidelines as well as easy exercise prescription methods can improve the ability of physicians to prescribe exercise as a therapeutic option. In addition, identifying barriers to compliance with exercise and ways to overcome these barriers is also necessary in order to use ther...
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
AbstractPurposeThis retrospective study aimed to determine the efficacy of an integrated active, rehabilitation protocol in patients  ≥ 65 years of age with chronic mechanical low back pain and compare the results in similar patients in 50–64 years age group.MethodsPre- and post-treatment mean numerical pain rating scale (NPRS) score, mean Oswestry disability index (ODI) score, treatment outcome category and minimal clinically important difference (MCID) thresholds achieved for NPRS and ODI scores post-treatment were compared among 697 patients in the 50 –64 years and 495 patient...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Abstract An 87-year-old woman with a history of osteoporosis presented to the emergency department with complaints of low back pain and difficulty walking due to falling onto her left hip 2 weeks prior. Given the delay in diagnostic evaluation and persistent symptoms, computed tomography (CT) of the lumbar spine was ordered. The results of the CT were read as noncontributory and a physical therapist was consulted. Following examination, the physical therapist recommended left hip radiographs. A CT scan of the hip, which was ordered due to its superior specificity in detecting subtle fractures and to assist interve...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: J Orthop Sports Phys Ther Source Type: research
AbstractSummaryA total of 88 subjects were enrolled to investigate the relationship between paraspinal muscle fatty infiltration and lumbar bone mineral density (BMD) using chemical shift encoding-based water-fat MRI and quantitative computed tomography (QCT), respectively. A moderate inverse correlation between paraspinal muscle proton density fat fraction and lumbar QCT-BMD was found with age, sex, and BMI controlled.PurposeTo investigate the relationship between paraspinal muscle fatty infiltration and lumbar bone mineral density (BMD).MethodsA total of 88 subjects were enrolled in this study (52 females, 36 males; age,...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
Authors: Piaserico S, Linder D, Messina F, Alaibac M Abstract In the present case report, a 32-year-old man with a 20-year long history of psoriasis, who presented with severe lower back pain and had no records of previous trauma, is reported. The patient reported the regular use of clobetasol cream, for 8 years, at an average dosage of 100 grams (g) per week. At the time of visit, the patient presented with severe psoriasis, which was associated with a cushingoid appearance. An X-ray of the spine was performed and the results revealed diffuse vertebral collapse that was caused by osteoporosis. The patient was diag...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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