Low Back Pain Share this page. Pain in the lower back area that can relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area. The Lancet Journal Series|Low back pain| Volume , ISSUE , P, June 09, .. Table 1Evidence of prevention strategies for low back pain: conclusions on effectiveness (and GRADE strength of. The Orthopaedic Section, APTA, Inc, and the Journal of Orthopaedic Acute or subacute low back pain with mobility deficits (b Mobility of several joints).


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When work-hardening is emphasised, it has been called functional restoration.

Pain relief is not an overt objective. Nor are a diagnosis and specific anatomical treatment pursued.


While proponents of multidisciplinary therapy have published favourable reviews of its efficacy for chronic pain in general, 36 a review focusing on chronic low back pain was less encouraging. The low back pain journal is contradictory on its effect on return to work.

However, these conclusions apply to intensive rehabilitation, which means intensive exercises.

Management of chronic low back pain | The Medical Journal of Australia

The available trials low back pain journal less intensive multidisciplinary rehabilitation did not show improvements in pain, function, or vocational outcomes when compared with non-multidisciplinary outpatient rehabilitation or usual care.

In these low back pain journal, pain scores were reduced from 5. In these terms, multidisciplinary therapy cannot be regarded as curative. For some patients, it offers the possibility of better pain control and improved function, but overall it amounts only to palliative therapy.

Pursuing a cure has been criticised on the grounds that it ignores the psychosocial aspects of chronic pain.


Nevertheless, proponents of reductionism have persisted, as monotherapies and multidisciplinary therapy have not provided a satisfying solution to chronic low back pain. Joint blocks can be used to pinpoint pain from the sacroiliac joint or the low back pain journal zygapophysial joints.

It is characterised by radial and circumferential fissures in the anulus fibrosus of the affected disc, in association with a degraded nuclear matrix; externally the disc is intact. This is true if investigations are limited to CT or MRI, but a diagnosis becomes possible if diagnostic blocks and discography are used.

These investigations are not indicated for every patient with chronic low back low back pain journal. They are indicated if there is a desire or need to know. They have diagnostic utility in that they bring about closure.

They prevent the futile pursuit of a diagnosis by other non-valid means.

Low Back Pain | List of High Impact Articles | PPts | Journals | Videos

They may have a beneficial psychological effect; patients may be relieved to have an explanation low back pain journal their pain. For medicolegal purposes, establishing a diagnosis under controlled conditions protects patients from accusations of malingering or imagining their pain.

Target-specific treatment The ultimate measure of a diagnostic test is its therapeutic utility. In the past, pursuing a pathoanatomical diagnosis of low back pain could be criticised on the low back pain journal that the diagnosis did not alter treatment.

Journal of Pain & Relief

This is no longer the case. Zygapophysial joint pain can be treated with radiofrequency medial branch neurotomy.

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However, the hazards of this major surgery, and its questionable efficacy, have prompted the exploration low back pain journal minimally invasive alternatives. One of these has been intradiscal electrothermal therapy IDETin which the fissures of the painful disc are coagulated percutaneously with flexible electrodes introduced into the disc.


Launched on the basis low back pain journal observational studies, this treatment became controversial for lack of controlled trials. One study has now shown that IDET is more effective than physical rehabilitation; 21 and a forthcoming study found it to be significantly more effective than placebo for relieving pain and improving function.

These patients have generally been treated with multidisciplinary therapy, spinal cord stimulation or intraspinal opioids.