Treatment of Discogenic Low Back Pain: Current Treatment Strategies and Future Options —a Literature Review

AbstractPurpose of ReviewMany studies have demonstrated that discogenic low back pain is the most common type of chronic low back pain (CLBP), one of the major causes of disability, and has a major socioeconomic impact. Our aim is to review present therapeutic interventions for discogenic low back pain.Recent FindingsThere are a multitude of treatments used in clinical practice to treat CLBP, but there is continued debate and lack of consensus among clinicians and the policy makers as to which modality is the best approach. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chronic back pain without disc herniation in 26 to 39% of patients. Treatment modalities include noninvasive treatments such as drug therapy, multiple physical modalities, and multidisciplinary biopsychosocial rehabilitation; interventional modalities such as intradiscal therapies and epidural injections; and regenerative modalities with disc injections of various solutions; and, finally, surgical approaches such as fusion and artificial disc replacement, all of which are accompanied by significant discussion, limited evidence, and lack of consensus.SummaryThe results of this evaluation show that the evidence for drug therapy in chronic discogenic low back pain is limited; for multidisciplinary biopsychosocial rehabilitation, it is moderate; and for multiple physical and behavioral therapies, the evidence is limited. For intradiscal therapies, it is poor; for e...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research

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AbstractPurpose of ReviewBack pain is a growing problem worldwide, incurring enormous economic costs and disability. Current treatment modalities often provide adequate relief but fail to address underlying conditions. Regenerative cellular modalities aim to restore anatomical function in degenerative conditions which may cause low back pain. Platelet-rich plasma (PRP) consists of an increased concentration of autologous platelets suspended in a small amount of plasma. PRP can be administered via injection or topically and is prepared using various techniques.Recent FindingsWhile a unifying mechanism of action is not well ...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
Publication date: Available online 24 June 2019Source: The LancetAuthor(s): Maigeng Zhou, Haidong Wang, Xinying Zeng, Peng Yin, Jun Zhu, Wanqing Chen, Xiaohong Li, Lijun Wang, Limin Wang, Yunning Liu, Jiangmei Liu, Mei Zhang, Jinlei Qi, Shicheng Yu, Ashkan Afshin, Emmanuela Gakidou, Scott Glenn, Varsha Sarah Krish, Molly Katherine Miller-Petrie, W Cliff Mountjoy-VenningSummaryBackgroundPublic health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount importance. This analysis uses data from the...
Source: The Lancet - Category: General Medicine Source Type: research
Pain is a significant public health problem affecting approximately 20% of adults in the United States (US).4,11,14 However, specific data are lacking on the incidence, prevalence, and outcomes of most common pain conditions. Health services research on chronic pain has typically focused on single pain conditions, such as low back pain or headache, despite an increasing recognition of multiple chronic overlapping pain conditions.13 Focusing on single pain conditions can limit understanding of the effects of chronic pain, as those who are most disabled by chronic pain and use the most health care services typically suffer f...
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Original Reports Source Type: research
Authors: Ceylan A, Aşık İ, Özgencil GE, Erken B Abstract Background/aim: We aimed to compare the results of the treatment of the patients with failed back surgery syndrome (FBSS) by mechanical lysis and steroid hylase injection via epiduroscopy due to their stabilization status and to detect the effect of pathological diagnostic markers on prognosis and ongoing treatment protocol. Materials and methods: Eighty-two patients with FBSS symptoms were included. Two groups were composed as group I (stabilized) and group II (nonstabilized). All patients were evaluated using the oswestry disability index (ODI) ...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
Abstract Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, comparable with other standard treatments. When compared with oral analgesics, cervical manipulation and/or mobilization appears to provide better short-term pain relief and improved function in patients with neck pain. Manipulative therapies may be as effective as amitriptyline for treating migraine headaches and can reduce the...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
If you are one of the more than 100 million Americans suffering with chronic pain, you know how desperate you can get searching for relief. For constant or chronic pain, sometimes knowing that you can only get temporary relief from medications sits at the back of your brain and sets up pain anticipation. Shouldn’t there be a better way, an approach or approaches that don’t rely on pharmaceutical drugs to combat pain? According to new research, there are some new pain relief methods that look very promising to do just that. Treatment from Strangers Mat Provide Unexpected Pain Relief It may seem counter-intuitiv...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Chronic Pain Health-related Mental Health and Wellness Mindfulness Psychology Research Treatment Source Type: blogs
Over the past few years I’ve been pondering the presumed gap between people living with pain and the people who “treat” or work with them.  Most of my readers will know that I live with widespread pain (aka fibromyalgia) or pain that is present in many parts of my body, and the associated other symptoms like DOMS that last for weeks not a day or two, and increased sensitivity to heat, cold, pressure, chilli, sound and so on. I first “came out” with my pain about 15 years ago: that is, I first disclosed to people I worked with that I had this weird ongoing pain – and finally joined...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Professional topics Research Therapeutic approaches inclusion inequality Source Type: blogs
For over 20 years, Linda Buonanno lived in fear that her irritable bowel syndrome (IBS) would suddenly interrupt her daily routine with frequent trips to the bathroom and unbearable cramping. Buonanno, now a 71-year-old medical assistant and hairdresser from Methuen, Mass., tried everything from drugs to dairy-free diets. Nothing worked. She remembers a particularly tough period over 10 years ago, when she was working on the factory floor of a medical-device company for up to 10 hours a day, six days a week. When an IBS episode would strike, her co-workers would cover for her as she huddled in a corner, keeled over in pain...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized medicine Research Source Type: news
AbstractMigraine remains one of the biggest clinical case to be solved among the non-communicable diseases, second to low back pain for disability caused as reported by the Global Burden of Disease Study 2016. Despite this, its genetics roots are still unknown. Its evolution in chronic forms hits 2 –4% of the population and causes a form so far defined Medication Overuse Headache (MOH), whose pathophysiological basis have not been explained by many dedicated studies. The Global Burden of Disease Study 2016 has not recognized MOH as independent entity, but as a sequela of Chronic Migraine. Th is concept, already repor...
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
As I read blogs and tweets and posts on social media, and even peer reviewed papers in journals, I often read that what we’re trying to do in sub-acute pain management is to prevent chronic pain from developing (note, when I talk about pain that goes on beyond healing, more than three months, or has no useful function, I may use the term “chronic” or I may use the more recent term “persistent” – they mean the same thing, except persistent has perhaps less baggage…). I want to take aim at that focus – to prevent pain from persisting – and think carefully about it. Let&r...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Pain conditions Professional topics acceptance biopsychosocial disability healthcare pain management rehabilitation science treatment Source Type: blogs
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