Evidence for managing chronic low back pain in primary care: a review of recommendations from high-quality clinical practice guidelines.

Conclusions: This study showed a partial progress in respect of the methodological quality of the Clinical practice Guidelines. Several AGREE II domains demonstrated low scores, particularly the "applicability" and "monitoring and auditing criteria" are the domains most susceptible to amendments in future. Implications for rehabilitation Clinicians should be aware that among recently published/updated clinical practice guidelines for the management of chronic low back pain in primary care only few were deemed to have high quality. Increasing evidence suggests the efficacy for self-management to improve low back pain outcome. Physical treatments are recommended in order to improve low back pain outcome while many physical modalities such as TENS, ultrasound, laser therapy are not. Psychological treatments are recommended and should be included as part of a broader treatment plan. PMID: 31368371 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research

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Low back pain, neck pain and other musculoskeletal disorders are among the ten leading causes of years lived with disability worldwide in 2016.12 Despite the wide range of treatments and health care resources devoted to low back pain, back-related disability and population burden have increased 10,11,14 and this development has recently called for international action.2 Since the US opioid crisis, the value of analgesics in general and of opioids in particular in the treatment of chronic pain is under discussion.
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Review Article Source Type: research
This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strateg y to manage cLBP and to address current shortcomings of cLBP treatment.Methods/designFor this prospective randomized controlled study, participants will be randomly assigned to three groups: (1)APA group (active points related to cLBP), (2) Comparison group-1 (non-active points, unrelated to cLBP), and (3) Comparison group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessmen...
Source: Trials - Category: Research Source Type: clinical trials
CONCLUSIONS: The most important variables were the prone instability test, pelvic tilt test, straight leg raise, body weight, visual analogue scale and the short form 36 health survey. PMID: 31929137 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
Conclusion: Tissue stiffness might not be related to pain experience in patients with chronic neck and lower back pain. Trial registration: German Clinical Trial Register (DRKS00011281). PMID: 31929809 [PubMed]
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
CONCLUSION: An integrated rehabilitation programme was no more effective than an existing rehabilitation programme at the 26-week follow-up. PMID: 31912752 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
The 20-week lumbar stabilization exercise and muscle strengthening exercise programs were efficacious in decreasing LBP and functional disability in people performing sedentary work, however the lumbar stabilization exercise program was more effective, and this effect lasted for 12  weeks after completion of the program.
Source: Clinical Biomechanics - Category: Orthopaedics Authors: Source Type: research
Conclusions: Both techniques were equivalent in pain reduction but DiscoGel® had a greater effect on decreasing disability after 12 months, although the rate of progression to secondary treatments and/or surgery was almost equal in the two groups. PMID: 31888320 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
This study is a randomized, assessor-blinded, multicenter, clinical trial with two parallel groups. Four Korean medicine hospitals will recruit 84 participants and randomly allocate them into the control or treatment group in a 1:1 ratio. The control group will receive acupuncture treatment at 11 local and 4 distal acupuncture points for 20  min twice a week for 6 weeks. The treatment group will receive the same acupuncture treatment as the control group and also take Palmijihwang-hwan for 6 weeks. The primary outcome will be the change in visual analog scale (VAS) score between baseline (visit 1) and completion of ...
Source: Trials - Category: Research Source Type: clinical trials
ConclusionsOpioids may provide a safe and clinically relevant pain relief for 4 –15 weeks in highly selected patients.SignificanceWithin the context of randomized controlled trials of 4 –15 weeks, opioids provided a clinically relevant pain relief of 30% or greater and a clinically relevant reduction of disability compared to placebo in non‐malignant chronic low back pain. Number needed to treat for an additional drop out due to side effects was 11 (95% confidence interval: 6– 33). Assessment of abuse and addiction was incomplete. The frequency of serious adverse events including deaths did no...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: REVIEW ARTICLE Source Type: research
In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disabi...
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
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