Acute Back Pain and Sciatica

Vertebral sarcoidosis with associated Darier-Roussy disease manifesting as acute back pain

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2021.101330 ◽

2021 ◽

pp. 101330

Author(s):

Mohamad Syafeeq Faeez ◽

Naveen Rajadurai ◽

Thajunnisa Hassan ◽

Alias Mardziah ◽

Robert Penafort ◽

...

Keyword(s):

Back Pain ◽

Acute Back Pain

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Federal Acute Back Pain Guideline Recommends Medication, Spinal Manipulation, and Exercise Most Patients Can Safely Defer Specialized Diagnostic Testing

The Back Letter ◽

10.1097/00130561-199501000-00001 ◽

1995 ◽

Vol 10 (1) ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

&NA;

Keyword(s):

Back Pain ◽

Spinal Manipulation ◽

Diagnostic Testing ◽

Acute Back Pain

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Acute Back Pain in a Child

Orthopedics ◽

10.3928/0147-7447-20010101-07 ◽

2001 ◽

Vol 24 (1) ◽

pp. 20-20

Author(s):

Charles Sorbie

Keyword(s):

Back Pain ◽

Acute Back Pain

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Osteopathic correction in the treatment of pain in the lower back

Russian Osteopathic Journal ◽

10.32885/2220-0975-2020-1-2-140-146 ◽

2020 ◽

pp. 140-146

Author(s):

V. O. Belash ◽

Yu. O. Novikov

Keyword(s):

Back Pain ◽

Developed Countries ◽

Economic Problem ◽

World Health ◽

Randomized Controlled ◽

Lower Back ◽

The World ◽

Working Age ◽

Acute Back Pain ◽

Health Organization

According to experts of the World Health Organization the lower back pain (LBP) prevalence in developed countries reaches the pandemic size, and it is a serious medical and socio-economic problem. Acute back pain is transformed into chronic in 10–20 % of working age patients′ cases; this causes serious psychological disorders appearing, forms painful behavior and persists even when the initial pain trigger is eliminated. Data from metaanalyses of randomized controlled trials indicate the effectiveness of the osteopathic approach in the treatment of LBP patients. At the same time the osteopathic correction is effective not only for acute pain, but also for chronic pain. A case from clinical practice is described demonstrating the possibility of osteopathic correction of a LBP patient.

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Watchful Waiting as a Strategy to Reduce Low-Value Spinal Imaging: Study Protocol for a Randomized Trial

10.21203/rs.3.rs-142884/v2 ◽

2021 ◽

Author(s):

Joshua Fenton ◽

Anthony Jerant ◽

Peter Franks ◽

Melissa Gosdin ◽

Ilona Fridman ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Watchful Waiting ◽

Standardized Patient ◽

Low Back ◽

Patient Trust ◽

Post Intervention ◽

Acute Low Back Pain ◽

Spinal Imaging ◽

Acute Back Pain

Abstract Background: Patients with acute low back pain frequently request diagnostic imaging, and clinicians feel pressure to acquiesce to such requests to sustain patient trust and satisfaction. Spinal imaging in patients with acute low back pain poses risks from diagnostic evaluation of false-positive findings, patient labeling and anxiety, and unnecessary treatment (including spinal surgery). Watchful waiting advice has been an effective strategy to reduce some low-value treatments, and some evidence suggests a watchful waiting approach would be acceptable to many patients requesting diagnostic tests. Methods: We will use key informant interviews of clinicians and focus groups with primary care patients to refine a theory-informed standardized patient-based intervention designed to teach clinicians how to advise watchful waiting when patients request low-value spinal imaging for low back pain. We will test the effectiveness of the intervention in a cluster randomized clinical trial. We will recruit 8-10 primary care and urgent care clinics (~55 clinicians) in Sacramento, CA; clinicians will be randomized 1:1 to intervention and control groups. Over a 3 to 6 month period, clinicians in the intervention group will receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain; SPIs will instruct clinicians in a three-step model emphasizing establishing trust, empathic communication, and negotiation of a watchful waiting approach. Control physicians will receive no intervention. The primary outcome is the post-intervention rate of spinal imaging among actual patients with acute back pain seen by the clinicians adjusted for rate of imaging during a baseline period. Secondary outcomes are: use of targeted communication techniques during a follow-up visit with an SP; clinician self-reported use of watchful waiting with actual low back pain patients; post-intervention rates of diagnostic imaging for other musculoskeletal pain syndromes (to test for generalization of intervention effects beyond back pain); and patient trust and satisfaction with physicians. Discussion: This trial will determine whether standardized patient instructors can help clinicians develop skill in negotiating a watchful waiting approach with patients with acute low back pain, thereby reducing rates of low-value spinal imaging. The trial will also examine the possibility that intervention effects generalize to other diagnostic tests. Trial registration: NCT 04255199, ClinicalTrials.gov (January 20, 2020)

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