Back Pain - Sciatica

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Back Pain - Sciatica

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NEWS:

Study Shows Patients with Herniated Disks Improve Over Time – Even without Surgery "National Institutes of Health, gives doctors and patients reason to reconsider surgery when planning treatment for herniated disks. In the 13-center study of candidates for lumbar diskectomy, researchers found that those who forwent surgery for nonoperative care fared similarly to those who had the surgery. In general, surgery patients experienced slightly more improvement over the study period, and particularly in the first 3 months, than those who opted for other treatments."

ARTICLES:

Definition of Herniated disc

Low Back Pain — Frequently Asked Questions (FAQs)

JOURNAL ARTICLES:

Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. (Spine. 2006) "Low back pain lasting at least a whole day in the past 3 months was reported by 26.4% of respondents, and neck pain was reported by 13.8%. Among racial groups, American Indians and Alaska Natives had the highest prevalence of low back pain, and Asian Americans had the lowest. Prevalence generally declined with greater levels of education and increasing income."

BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. (Eur Spine J. 2006)

Chronic back pain among the elderly: prevalence, associations, and predictors. (Spine. 2006) "CONCLUSION: CBP is increasingly common in the elderly. Psychosocial factors, female gender, hypertension, and existing joint pain identify individuals most at risk."

Comorbid Subjective Health Complaints in Low Back Pain. (Spine. 2006) "CONCLUSIONS.: Our findings indicate that patients with low back pain suffer from what may be referred to as a "syndrome," consisting of muscle pain located to the whole spine as well as to legs and head, and accompanying sleep problems, anxiety, and sadness/depression."

Comorbidity of low back pain: Representative outcomes of a national health study in the Federal Republic of Germany. (Eur J Pain. 2006) "RESULTS: One in three Germans (34%) experienced back pain during the seven days prior to being interviewed. The one-year prevalence rate is 59%. All the morbidities investigated by us are more common in subjects with back pain than in individuals without back pain. The most common comorbidities associated with back pain are musculoskeletal disorders like rheumatoid arthritis, osteoarthritis and osteoporosis, followed by cardiovascular and cerebrovascular disease."

Do psychological factors predict outcome in both low back pain and shoulder pain? (Ann Rheum Dis. 2006) "CONCLUSION: The results show that psychological factors, with the exception of fear-avoidance beliefs, are more strongly associated with persistent pain and disability in patients with LBP than in SP. This seems to indicate that in a primary care population the influence of psychological factors on outcome may vary across patients with different types of pain."

Does minor trauma cause serious low back illness? (Spine. 2006)

Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. (Radiology. 2006) "CONCLUSION: Proton MR spectroscopy demonstrates a significantly higher fat content in the multifidus muscle in patients with chronic LBP than in asymptomatic volunteers."

Impact of low back pain on functional limitations, depressed mood and quality of life in patients with rheumatoid arthritis. (Pain. 2006) "The prevalence of LBP in RA patients was 53.4%. RA patients with LBP displayed a significantly higher degree of disability and depression than RA patients without LBP."

Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young twin population. (BMC Musculoskelet Disord. 2006) "Young people from 12 to 22 years of age with persistent LBP during the previous year have an odds ratio of 3.5 persistent LBP eight years later. Both headache and asthma are also positively associated with future LBP and there is a large clustering of LBP, headache and asthma in adolescence."

Is every chronic low back pain benign? Case report. (Surg Neurol. 2006) "CONCLUSIONS: The evaluation of a patient with chronic back pain needs a thorough clinical and radiological workup. Limited evaluation of the bony and nervous structures of the spinal canal radiologically is insufficient. Pre- and paravertebral structures as well as vertebral body should carefully be evaluated to diagnose other causes of pain."

Lumbar spine MRI in the elite-level female gymnast with low back pain. (Skeletal Radiol. 2006) "RESULTS: Anterior ring apophyseal injuries (9/19) and degenerative disk disease (12/19) were common. Spondylolysis (3/19) and spondylolisthesis (3/19) were found. Focal bone-marrow edema was found in both L3 pedicles in one gymnast. History and physical exam revealed four gymnasts with current low back pain at the time of imaging. There were findings confined to those athletes with current low back pain: spondylolisthesis, spondylolysis, bilateral pedicle bone-marrow edema, and muscle strain."

Predictors of pain and function in persons with spinal stenosis, low back pain, and no back pain. (Spine. 2006) "CONCLUSION: Clinically recognized spinal stenosis is fluctuating and largely improving, and in continuum with back pain and no symptoms. Since anatomic and neurologic deficits do not predict future function, they should not be weighed heavily in surgical risk-benefit discussions."

Sciatica in a patient with unusual peripheral nerve sheath tumors. (Surg Neurol. 2006) "CONCLUSION: This case emphasizes the importance of continued investigation when the radiographic findings do not correlate with the patient's history in the presence of localizing signs on physical examination."

Senescence in human intervertebral discs. (Eur Spine J. 2006) "Intervertebral discs demonstrate degenerative changes relatively early in life. Disc degeneration, in turn, is associated with back pain and disc herniation, both of which cause considerable clinical problems in the western world. Cell senescence has been linked to degenerative diseases of other connective tissues such as osteoarthritis. Thus we investigated the degree of cell senescence in different regions of discs from patients with different disc disorders. … This study demonstrates an increased degree of cell senescence in herniated discs, particularly in the nucleus where cell clusters occur. These clusters have been shown previously to form via cell proliferation, which is likely to explain the increased senescence. These findings could have two important clinical implications: firstly, that since senescent cells are known to behave abnormally in other locations, they may lead to deleterious effects on the disc matrix and so contribute to the pathogenesis …"

Soft tissue determinantsof low back pain. (Curr Pain Headache Rep. 2006) "Low back pain is one of the complaints most commonly seen in the clinical setting. Correctly or incorrectly, these patients are often given the diagnosis of fibromyalgia, myofascial pain syndrome, disk herniation, or some other label. It is important to recognize the soft tissue causes of low back pain and understand how they can be most appropriately diagnosed and managed. Nonligamentous disorders of the low back region may occur in isolation or in combination with underlying discogenic, ligamentous, and facet-mediated causes of pain."

The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. (Spine. 2006)

The influence of diabetes mellitus on lumbar intervertebral disk herniation. (Surg Neurol. 2006) "CONCLUSIONS: Patients operated on for lumbar disk disease have a statistically significant increased incidence of diabetes mellitus compared with similar patients operated on for other reasons. This difference cannot be explained by diagnostic uncertainties because if patients with diabetic polyneuropathy were wrongly operated on for lumbar disk disease, their results would not be as good as those of the other patients operated on for lumbar disk disease. Diabetes mellitus must be a predisposing factor in patients operated on for lumbar disk disease."

What is Intervertebral Disc Degeneration, and What Causes It? (Spine. 2006)

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