Pharmacotherapy in lower back pain

In the US, back pain is the second most common cause of disability and the leading cause among men, with approximately 45% of the adult population experiencing lower back pain annually and a direct cost for diagnosis and treatment reported to be higher than 23 billion US dollars in 1990. However, despite the high prevalence of this condition, lower back pain diagnoses are commonly imprecise, and specific causes for lower back pain can only be determined in approximately 15% of patients. So, although for most patients with acute lower back pain, a simple cause-and-effect model can be described, often the result of a lumbar sprain or strain, clinicians must be alert to a variety of other conditions which may present in a similar fashion and require more emergent care. Pharmacotherapy and nondrug-related modalities have been shown to reduce pain and other related symptoms. Medication classes with known benefit include the nonsteroidal antiinflammatory drugs (NSAIDs), skeletal muscle relaxants, opioids, acetaminophen and the newer cyclooxygenase-2 (COX-2) inhibitors. This review analyzes the different drugs available for treating lower back pain in light of the most recent evidence coming from clinical studies. More critical research is needed to further define the roles of these medications in treating pain associated with lower back injury.     

The pharmacological management of chronic lower back pain

ABSTRACT

Introduction

Treating chronic low back pain (LBP) can be challenging, and the most effective pharmacological therapy is controversial. The present systematic review investigated the efficacy of various pharmacological compounds to achieve pain relief and improve disability in chronic LBP patients. The present study focused on acetaminophen, amoxicillin, flupirtine, baclofen, tryciclic antidepressants (TCAs), duloxetine, topiramate, gabapentinoids, non-steroid anti-inflammatory drugs (NSAIDs) and opioids.     

胺碘酮致电击样下背痛

1例50岁男性患者因心律失常给予胺碘酮150 mg静脉泵入,约5 min时出现电击样下背痛,伴面色苍白,立即停止泵入药物。停药后约15 min,患者背痛症状完全缓解。缓解后10 min再次静脉泵入胺碘酮,约3 min后患者再次出现电击样下背痛,立即停药。停药后约5 min,患者背痛症状完全消失。     

某部新训士兵下腰痛分析刁

目的 了解某部新兵在入伍基础军事训练期间发生的下腰痛的特点,为部队制定相应的预防措施提供科学依据.方法 调查了该部队2006年度535名新兵的入伍基础军事训练情况,设计下腰痛调查表,通过问卷调查了解下腰痛发病情况,并进行分类调查统计.结果 参训新兵446人在基础军事训练期间发生下腰痛135人,患病率为30.27%.在新兵基础训练期间,在第1个月末和第2个月末各有一个发病高峰.结论 训练负荷过大所导致的软组织过劳性损伤最为重要.因此,在平常的军事训练中,应该加强健康宣教工作,在新兵训练过程中要注意科学施训,循序渐进,减少下腰痛的发生.     

Using databases for studying and comparing health care costs and resource use

Data sources such as medical insurance claims are increasingly used in health outcomes research. We present opportunities and limitations associated with the use of such data for conducting studies of health care costs and resource use. We also provide examples on using databases for conducting research when the primary objective is to study costs or resource use. This information is intended to be helpful to experienced health services researchers and to those new to the field of either outcomes research or cost effectiveness research. We examine the reasons for using databases to study costs and resource use, desirable attributes of databases used for this purpose, potential pitfalls, other issues associated with conducting cost and resource use studies with databases, and appropriate methods for this research. Through examples and references, we examine issues to be considered in each of these areas, and make recommendations. Strengths and limitations of databases are indicated. Research using claims data to determine health care cost and resource use should be carried out responsibly. Limitations must be acknowledged for research using databases, and appropriate methods must be used. Still, databases represent a rich opportunity to conduct research in health care costs and resource use, and much can be learned using databases. Copyright © 2001 John Wiley & Sons, Ltd.     

Acupuncture for chronic neck pain

Sahin N, Ozcan E, Sezen K, Karatas O, Issever H. Efficacy of acupuncture in patients with chronic neck pain – a randomised, sham controlled trial. Acupunct Electrother Res 2010; 35: 17–27.     

Acupuncture for herpes zoster pain

Ursini T, Tontodonati M, Manzoli L, Polilli E, Rebuzzi C, Congedo G, Di Profio S, Marani Toro P, Consorte A, Placido G, Laganà S, D'Amario C, Granchelli C, Parruti G, Pippa L, VZV Pain Study Group. Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open‐label, randomized trial in the VZV pain study. BMC Complement Altern Med 2011; 11: 46.     

Impact of smoking on health care resource use

This study examined a sample of almost 1000 women in terms of the impact of cigarette smoking on their experience of various physical conditions and on their use of various health care facilities. Smokers reported more frequent complaints and illness episodes than non smokers. They also made more visits to general practitioners and had more hospital admissions during the 12 months prior to the study. When age groups were examined separately, the differences were found to be more evident amongst the younger groups than the older.     

Chiropractic combination treatments for back pain

Walker BF, French SD, Grant W, Green S. Combined chiropractic interventions for low‐back pain. Cochrane Database Syst Rev 2010; 4: CD 005427.