A randomized placebo-controlled trial of desipramine, cognitive behavioral therapy, and active placebo therapy for low back pain

This clinical trial evaluated the independent and combined effects of a tricyclic antidepressant (desipramine) and cognitive behavioral therapy (CBT) for chronic back pain relative to an active placebo treatment. Participants (n = 142) were patients experiencing daily chronic back pain at an intensity of ≥4/10 who were randomized to a single-center, double-blind, 12-week, 4-arm, parallel groups controlled clinical trial of (1) low concentration desipramine titrated to reach a serum concentration level of 15 to 65 ng/mL; (2) CBT and active placebo medication (benztropine mesylate, 0.125 mg); (3) low concentration desipramine and CBT; and (4) active benztropine placebo medication. Participants completed the Differential Description Scale and Roland Morris Disability Questionnaires before and after treatment as validated measures of outcomes in back pain intensity and disability, respectively. Participants within each condition showed significant reductions from pre-treatment to post-treatment in pain intensity (mean changes ranged from = −2.58 to 3.87, Cohen's d's = 0.46-0.84) and improvements in pain disability (mean changes = −3.04 to 4.29, Cohen's d's = 0.54-0.88). However, intent-to-treat analyses at post-treatment showed no significant differences between any condition, with small effect sizes ranging from 0.06 to 0.27. The results from this clinical trial did not support the hypothesis that desipramine, CBT, or their combination would be statistically super...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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ConclusionThe Arabic version of COMI-back represents a valid and reliable instrument for use in Arabic-speaking patients with non-specific LBP.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSION: This study shows that not all fields considered important by patients to their function are being evaluated, and emotional and contextual factors should be included in clinical assessments in order to fully understand patient need. PMID: 32646318 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. PMID: 32623724 ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). SETTING: Governmental and private institutions. PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. INTERVENTIONS: The EG received full version of the applic...
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
In this study, causal mediation analysis was used to determine whether the effect of CFT on disability and the lack of effect on pain (relative to a group exercise and educati on intervention) is mediated by certain psychological and lifestyle factors. Hypothesised mediators measured were pain self‐efficacy, stress, fear of physical activity, coping, depression, anxiety, and sleep, at 6 months. The outcomes measured were functional disability and pain intensity at 12 mo nths. This causal mediation study shows that the majority of benefit of CFT (relative to a group exercise and education intervention) for disability is d...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
To evaluate the effects of water and mat Pilates on pain, disability, and static and dynamic balance in patients with chronic nonspecific low back pain (CNLBP).
Source: Journal of Bodywork and Movement Therapies - Category: Physiotherapy Authors: Tags: Prevention and Rehabilitation Source Type: research
Conclusion: Patients with CLBP perceived multiple outcomes from physiotherapy treatment that cover the domains of global, physical, mental and social health. These study findings suggest that the targets of measurement for physiotherapy need to be expanded in order to reflect outcome domains valued by patients.Implications for rehabilitationMinimum important changes in pain intensity and disability were not valid indicators of global improvements as perceived by patients.Patients with chronic low back pain undergoing physiotherapy perceived gains in multiple health domains that ranged beyond pain and disability domains.Phy...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
This study was conducted to determine the validity and reliability of the Body Awareness Questionnaire (BAQ) in patients with non-specific chronic low back pain. A total of 180 participants (96 women, 84 men), aged 21 –64 years, with non-specific chronic low back pain were enrolled from June to December 2019. Sociodemographic features were collected. The pain intensity using the Visual Analog Scale, the disability status due to low back pain with the Oswestry Disability Index (ODI), the body awareness level us ing the BAQ, and self-esteem using the Rosenberg Self-Esteem Scale (RSES) were assessed. Test–ret...
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
A new study has found that tanezumab, a monoclonal antibody that inhibits nerve activity, provides relief in patients with chronic low back pain, one of the leading reasons why people seek medical care and the number one cause of disability worldwide.
Source: University of Rochester Medical Center Press Releases - Category: Universities & Medical Training Authors: Source Type: news
(University of Rochester Medical Center) A new study has found that tanezumab, a monoclonal antibody that inhibits nerve activity, provides relief in patients with chronic low back pain, one of the leading reasons why people seek medical care and the number one cause of disability worldwide.
Source: EurekAlert! - Social and Behavioral Science - Category: International Medicine & Public Health Source Type: news
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