Addition of dexmedetomidine and neostigmine to 1.5 % lidocaine and triamcinolone for epidural block to reduce the duration of analgesia in patients suffering from chronic low back pain.

Addition of dexmedetomidine and neostigmine to 1.5 % lidocaine and triamcinolone for epidural block to reduce the duration of analgesia in patients suffering from chronic low back pain. J Med Life. 2019 Jul-Sep;12(3):260-265 Authors: Zargar S, Rafie AN, Sosanabadi A, Kamali A Abstract Lower back pain is one of the leading causes of disability in the world. The aim of this study was to evaluate the effect of supplementation of dexmedetomidine and neostigmine with lidocaine 1.5% and triamcinolone for epidural block in increasing the duration of analgesia among patients suffering from chronic low back pain. In this double-blind, randomized clinical trial, 33 patients with chronic low back pain were included in three groups of 11 patients for epidural blockage. Triamcinolone (40 mg/ml) was added to lidocaine 1.5% solution (2 cc/segment) for all three groups. In group N, neostigmine was used at a dose of 1 mg (mg), followed by group D (dexmedetomidine 35 μg [0.5 μg/kg]), and grou [ND (neostigmine 0.5 mg, and 35 μg dexmedetomidine, all of which were added to the triamcinolone and lidocaine solution in each group. Medications were injected into the epidural space using an interlaminar approach. Subsequently, scores of pain and duration of analgesia were recorded in questionnaires and analysed using SPSS version 23. One month after the injections, pain scores recorded in the N group were 7.6±1.4, followed by 5.88±1.2 in group D and 5.42 &pl...
Source: Journal of Medicine and Life - Category: General Medicine Tags: J Med Life Source Type: research

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The objective of this study was to evaluate if a single session of real or placebo cupping therapy in patients with chronic low back pain would be enough to temporarily reduce pain intensity and functional disability, enhancing their mechanical threshold and reducing local skin temperature. The outcome measures pain intensity using Brief Pain Inventory, pressure pain threshold, disability using the Roland Morris disability questionnaire, and low back skin temperature were assessed. This is an experimental clinical trial; after examination (AV0), patients were submitted to real or placebo cupping therapy (15 minutes, b...
Source: Journal of Acupuncture and Meridian Studies - Category: Complementary Medicine Source Type: research
Authors: Broadhead DY, Douglas HE, Bezjian Wallace LM, Wallace PJ, Tamura S, Morgan KC, Hemler DE Abstract Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report pr...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Study Design. Cross-sectional study. Objective. The aim of this study was to study the personal and societal impact of low back pain (LBP) in patients admitted to a multidisciplinary spine center. Summary of Background Data. The socioeconomic burden of LBP is very high. A minority of patients visit secondary or tertiary care because of severe and long-lasting complaints. This subgroup may account for a major part of disability and costs, yet could potentially gain most from treatment. Currently, little is known about the personal and societal burden in patients with chronic complex LBP visiting secondary/tertiary c...
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
Study Design. This is an observational cohort study. Objective. The aim of this study was to compare the effectiveness of PT to an interdisciplinary treatment approach in patients with chronic low back pain (CLBP). Summary of Background Data. CLBP is a costly and potentially disabling condition. Physical therapy (PT), cognitive behavioral therapy, and interdisciplinary pain programs (IPPs) are superior to usual care. Empirical evidence is lacking to clearly support one treatment approach over another in patients with CLBP. Methods. One hundred seventeen adult patients who completed an IPP for individuals with &g...
Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
Low back pain is the primary cause of adult disability worldwide and if poorly managed can precipitate the unnecessary use of opioids, diminish physical functioning, and lead to comorbid conditions interfering with patient quality of life. Providers who collaborate with a spinal interventionalist can effectively manage acute and chronic low back pain, improve physical functioning, and reduce the use of opioid analgesics. The implementation of specific spinal interventions, adjuvant analgesics, and collaboration with a multidisciplinary team can promote health and wellness for 1 of the most prevalent and debilitating global health conditions.
Source: The Journal for Nurse Practitioners - Category: Nursing Authors: Tags: Feature Article Source Type: research
CONCLUSION: Three sessions of thoracic manipulation, education, and exercise did not result in improved outcomes when compared to a sham manipulation, education, and exercise in individuals with chronic LBP. Future studies are needed to identify the most effective management strategies for the treatment of low back pain. Registered at clinicaltrials.gov (NCT02853357). LEVEL OF EVIDENCE: Therapy, level 1b. J Orthop Sports Phys Ther, Epub 6 Dec 2019. doi:10.2519/jospt.2020.8928. PMID: 31810405 [PubMed - as supplied by publisher]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: J Orthop Sports Phys Ther Source Type: research
Authors: Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA Abstract The aim of this study was to evaluate the effectiveness of the McKenzie method compared to manual therapy in the management of patients with chronic low back pain (CLBP). Randomised controlled trials evaluating the McKenzie method in treating CLBP in adults compared to manual therapy (MT) were searched in MEDLINE, CINAHL, Cochrane Library, and PEDro. The primary outcomes were pain and disability. Five trials were eligible for inclusion in the review, of which, most had a score of 8 out of 11 on the PEDro scale. At 2-3 months, all studies reported si...
Source: Journal of Musculoskeletal Neuronal Interactions - Category: Neurology Tags: J Musculoskelet Neuronal Interact Source Type: research
Abstract Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient's symptoms, the family physician is charged with providing reassurance, while also guiding the patient toward a return to function, which often includes maintaining employment. Evaluating for red flag signs and symptoms helps to eliminate concerning causes of low back pain, such as malignancy, fracture, infection, and cauda equina. Prescribing physical activity, including...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
AbstractBackgroundIn patients with chronic nonspecific low back pain (NCLBP), brain function changes due to the neuroplastic changes in different regions.AimThe current study aimed to evaluate the brain metabolite changes after spinal manipulation, using proton magnetic resonance spectroscopy (1H-MRS).MethodsIn the current study, 25 patients with NCLBP aged 20 –50 years were enrolled. Patients were randomly assigned to lumbopelvic manipulation or sham. Patients were evaluated before and 5 weeks after treatment by the Numerical Rating Scale (NRS), the Oswestry Disability Index (ODI), and1H-MRS.ResultsAfter t...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
CONCLUSIONS: We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain. PMID: 31765487 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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