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Musculoskelet Sci Pract 2021 May 29;55:102403. Epub 2021 May 29.

University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK; School of Health Sciences, University of Southampton, Highfield, Southampton, UK. Electronic address:

Background: Back pain guidelines endorse giving advice to enable people to self-manage and continue normal activities. Little is known however, about the content of advice that clinicians give and this project aimed to identify the advice given by clinicians to patients with back pain at their initial consultation.

Methods: A secondary analysis was conducted with 25 audio-recordings and transcriptions of consultations between patients with back pain and physiotherapists in a primary care outpatients department. Read More

Qual Life Res 2021 Jun 15. Epub 2021 Jun 15.

Ludwig Boltzmann Institute for Rehabilitation Research, Reizenpfenninggasse 1, 1140, Vienna, Austria.

Purpose: Patient- and clinician-reported outcome measures (PROMs, CROMs) are used in rehabilitation to evaluate and track the patient's health status and recovery. However, controversy still exists regarding their relevance and validity when assessing a change in health status.

Methods: We retrospectively analyzed the changes in a CROM (Fingertip-To-Floor Test - FTF) and PROMs (ODI, HAQ-DI, NPRS, EQ5D) and the associations between these outcomes in 395 patients with lower back pain (57. Read More

J Med Internet Res 2021 Jun 15;23(6):e27860. Epub 2021 Jun 15.

Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Background: The internet is used for information related to health conditions, including low back pain (LBP), but most LBP websites provide inaccurate information. Few studies have investigated the effectiveness of internet resources in changing health literacy or treatment choices.

Objective: This study aims to evaluate the effectiveness of the MyBackPain website compared with unguided internet use on health literacy, choice of treatments, and clinical outcomes in people with LBP. Read More

FP Essent 2021 Jun;505:18-22

99th MDG, Nellis Air Force Base, 4700 Las Vegas Blvd North, Las Vegas, NV 89191.

Acupuncture is used to manage pain and a variety of medical and psychological conditions. It modulates nociceptive areas of the brain, affects neuropeptide and purinergic signaling, and stimulates production of opioid neuropeptides. There are many types of acupuncture, including traditional, dry needling, laser, auricular, scalp, Japanese, and Korean. Read More

FP Essent 2021 Jun;505:11-17

F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.

Manual therapy, or manipulative therapy, is performed primarily by osteopathic physicians, chiropractors, and physical therapists to relieve pain and improve function. As safe prescribing of opioids has become a concern and nondrug therapies for pain management are used more widely, manual therapy has become an attractive treatment option for many patients. A variety of techniques are used, including myofascial release, strain-counterstrain, muscle energy, high velocity/low amplitude, Still, and others. Read More

Eur J Phys Rehabil Med 2021 Jun 15. Epub 2021 Jun 15.

Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany -

Background: In contrast to the broad evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) in chronic low back pain (CLBP) patients of working age, little is known about the benefit in patients aged ≥ 65 years.

Aim: To quantify the short-term and 12-month effects of a 3-week CLBP specific MBR program in patients ≥ 65 years of age; to compare the effects in patients ≥ 65 years of age to the effects in younger patients.

Design: Observational prospective cohort study. Read More

Prosthet Orthot Int 2021 Jun 11. Epub 2021 Jun 11.

Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, and Biomechanics Lab., Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedic and Spinal Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: The prevalent method for investigating the effect of therapeutic interventions on walking in the individuals with chronic low back pain (CLBP) is component-level approach in which all measurements focus on the spine component alone. However, this approach cannot disclose information about the overall function of the movement system such as complex walking patterns, which, in turn, reveal the underlying movement control.

Objectives: To compare the effect of 3-week wearing of lumbosacral orthosis (LSO) along with routine physical therapy with routine physical therapy alone on walking complexity in the individuals with nonspecific CLBP on the basis of the systems approach. Read More

Pain Manag Nurs 2021 Jun 11. Epub 2021 Jun 11.

Department of Physical Therapy, Federal University of Delta of Parnaíba, Parnaíba, Piauí, Brazil; Biomedical Master Science Program, Federal University of Delta of Parnaíba, Parnaíba, Piauí, Brazil. Electronic address:

Background: Recent studies indicate that the assessment of conditioned pain modulation (CPM) responses and emotional factors can provide important information regarding chronification mechanisms, choices for more efficient therapeutic strategies, and clinical variables supporting a therapeutic prognosis.

Aims: To investigate the impact of nonspecific chronic low back pain (NSCLBP) on CPM and psychosocial factors in individuals with NSCLBP compared with healthy controls.

Design: Case-control study. Read More

Trials 2021 Jun 14;22(1):398. Epub 2021 Jun 14.

Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China.

Background: Degenerative lumbar instability (DLI) is a common disease that causes low back pain (LBP) in clinic. It is difficult to completely recover from DLI, and it occurs repeatedly, which seriously affects the quality of life of patients. The epidemiological survey showed that 20-30% of low back pain was related to lumbar instability. Read More

Clin Neurol Neurosurg 2021 Jun 8;207:106755. Epub 2021 Jun 8.

Department of Neurosurgery, University of South Alabama, Mobile, AL, USA; Department of Political Science, University of South Alabama, Mobile, AL, USA. Electronic address:

Background: Spaceflight places astronauts in multiple environments capable of inducing pathological changes. Alterations in the spine have a significant impact on astronauts' health during and after spaceflight. Low back pain is an established and common intra-flight complaint. Read More

J Pak Med Assoc 2021 Apr;71(4):1058-1062

Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan.

Objective: To determine the effects of static exercise programme compared to Swiss ball training for core muscles of the lower back and pelvic region in patients with low back pain after child delivery.

Methods: The prospective single-blind randomised controlled trial was conducted at Rehabilitation department of Pakistan Railway General Hospital Rawalpindi from March to December 2018, and comprised patients with low back pain after delivery who were randomised into 2 equal groups. The subjects in Group A received static core exercises, while those in Group B got Swiss ball training. Read More

Biomed Res Int 2021 1;2021:6664864. Epub 2021 Jun 1.

Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Italy.

Background: The hypermobile type of Ehlers-Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue mainly characterized by joint hypermobility. Patients with hEDS suffer joint pain, in particular low back pain, commonly resistant to drug therapy. The aim of this research was to evaluate a neurocognitive rehabilitation approach based not only on the motion and function recovery but also on the pain management. Read More

Front Surg 2021 28;8:662919. Epub 2021 May 28.

Department of Industrial Engineering, Alma Mater Studiorum, Universita di Bologna, Bologna, Italy.

The number of patients with iatrogenic spinal deformities is increasing due to the increase in instrumented spinal surgeries globally. Correcting a deformity could be challenging due to the complex anatomical and geometrical irregularities caused by previous surgeries and spine degeneration. Virtual and 3D printed models have the potential to illuminate the unique and complex anatomical-geometrical problems found in these patients. Read More

Int J Sports Phys Ther 2021 Jun 1;16(3):636-650. Epub 2021 Jun 1.

ProRehab Physical Therapy.

Background And Purpose: Low back pain is one of the most common conditions occurring in the golfing population. Many approaches have been utilized throughout the years to address this condition including the concept of regional interdependence. The purpose of this case report is to describe the evaluation process and treatment approach of a golfer with low back pain using the principles of regional interdependence. Read More

Int J Sports Phys Ther 2021 Jun 1;16(3):628-635. Epub 2021 Jun 1.

Texas Woman's University.

Background: Individuals with chronic low back pain (CLBP) may demonstrate reduced ability to perform dynamic tasks due to fear of additional pain and injury in response to the movement. The Y-balance test (YBT) is a functional and inexpensive test used with various populations. However, the reliability and validity of the YBT used for assessing dynamic balance in young adults with CLBP have not yet been examined. Read More

J Pain Res 2021 4;14:1593-1600. Epub 2021 Jun 4.

Department of Spine Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.

Purpose: Percutaneous endoscopic lumbar discectomy for the treatment of far-migrated lumbar disc herniation (LDH) is clinically challenging. The aim of this study was to compare the efficacy and safety of interlaminar endoscopic lumbar discectomy (IELD) and interlaminar microscopic lumbar discectomy (IMLD) for the treatment of far-migrated LDH.

Materials And Methods: We retrospectively analyzed 50 consecutive cases of far-migrated LDH treated by IELD or IMLD. Read More

Clin Spine Surg 2021 Jun 14. Epub 2021 Jun 14.

Department of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, IL Hospital for Special Surgery, New York, NY.

Patients presenting to an outpatient spine clinic frequently report symptoms of low back pain with associated buttock, groin, and lower extremity pain. While many of these individuals suffer from lumbar spine radiculopathy, a number of different orthopedic pathologies can mimic these symptoms. Management depends substantially on a detailed history and physical examination, in addition to working from a broad list of differential diagnoses when evaluating these patients. Read More

J Orthop Sci 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Japan.

Background: To investigate the association between the central sensitization inventory (CSI), a screening tool for central sensitization, and the number of painful sites and the severity of pain in locomotive organs in an epidemiological study in the elderly.

Methods: A total of 379 individuals who underwent musculoskeletal disease screening were enrolled in this study. The CSI was used to assess symptoms of central sensitization. Read More

Int J Surg Case Rep 2021 Jun 9;84:106066. Epub 2021 Jun 9.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Introduction And Importance: Low voltage electrical injuries (less than 1000 V) can produce enough tetany to cause fractures, usually of the upper extremities. Simultaneous bilateral fractures of the femoral neck are an extremely rare occurrence. It is even more uncommon for a young healthy male to suffer significant fractures from a low voltage injury. Read More

Int J Surg Case Rep 2021 Jun 8;84:106092. Epub 2021 Jun 8.

Faculty of Medicine, University of Aleppo, Aleppo, Syria.

Introduction And Importance: Iliopsoas abscess is defined as the accumulation of suppurative fluid within the fascia surrounding the psoas and iliac muscles. Although some cases reported psoas abscess due to foreign body, to the best of our knowledge this is the first case of metal shrapnel causing psoas abscess.

Case Presentation: A 41 years old male presented to our center after a landmine explosion. Read More

J Clin Neurosci 2021 Jul 27;89:8-14. Epub 2021 Apr 27.

Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan; School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503, Japan.

It remains controversial whether preoperative low muscle mass affects clinical outcomes after lumbar surgery. Previous studies evaluated outcomes such as pain, quality of life, and disability, but none investigated preoperative low muscle mass and psychological factors. The purpose of this study was to clarify the association between preoperative low muscle mass and postoperative psychological factors in lumbar spinal stenosis (LSS). Read More

BMC Musculoskelet Disord 2021 Jun 12;22(1):533. Epub 2021 Jun 12.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

Background: With a rapidly aging population in Japan, locomotive syndrome is becoming an increasingly serious social problem. Exercise therapy using the lumbar type HAL, which is a wearable robot suit that can assist voluntary hip joint motion, would be expected to cause some beneficial effects for people with locomotive syndrome. The purpose of this study was to assess whether the deterioration of low back pain and any other adverse events would occur following HAL exercise therapy. Read More

Ann Palliat Med 2021 May 24. Epub 2021 May 24.

Hunan University of Chinese Medicine, Changsha, China.

Background: Acute low back pain (ALBP) is common and acupuncture therapy is a treatment option. The comparative efficacy and safety of different acupuncture therapies are still unclear. The aim of this network meta-analysis (NMA) was to evaluate and compare the efficacy and safety of different acupuncture therapies for ALBP. Read More

Clin Biomech (Bristol, Avon) 2021 May 28;87:105391. Epub 2021 May 28.

Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.

Background: Movement alterations due to low back pain (LBP) could lead to long-term adverse consequences if they do not resolve after symptoms subside. This study aims to determine if altered trunk control associated with recurrent low back pain persists beyond symptom duration.

Methods: Twenty young adults with recurrent LBP were tested once during an LBP episode and once in symptom remission, and twenty matched back-healthy participants served as controls. Read More

Spine J 2021 Jun 9. Epub 2021 Jun 9.

Department of Physiology, Korea University, Seoul, Republic of Korea. Electronic address:

Background Context: Low back pain is one of the most common musculoskeletal disorders. While the pathology of intervertebral disc (IVD) degeneration has been modeled using various biological methods, these models are inadequate for simulating similar pathological states in humans.

Purpose: This study investigated whether monosodium iodoacetate (MIA) injection into the IVD of rats could generate a reliable model of IVD degeneration. Read More

J Am Geriatr Soc 2021 Jun 12. Epub 2021 Jun 12.

Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.

Background/objectives: Gabapentinoids are commonly prescribed to relieve pain. The development of edema, an established adverse effect of gabapentinoids, may lead to a potentially harmful prescribing cascade whereby individuals are subsequently prescribed diuretics and exposed to diuretic-induced adverse events. The frequency of this prescribing cascade is unknown. Read More

Psychometrika 2021 Jun 12. Epub 2021 Jun 12.

Department of psychology, UCLA, Los Angeles, CA, 90095-1563, USA.

The reliable change index has been used to evaluate the significance of individual change in health-related quality of life. We estimate reliable change for two measures (physical function and emotional distress) in the Patient-Reported Outcomes Measurement Information System (PROMIS®) 29-item health-related quality of life measure (PROMIS-29 v2.1). Read More

Am J Nurs 2021 Jun 10. Epub 2021 Jun 10.

Margaret J. Carman is an associate professor in the School of Nursing, University of North Carolina at Chapel Hill. Contact author: The author and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the author is available at www.ajnonline.com.

Abstract: Although back pain is common, most often benign, and generally resolves in a few days with self-care, nonspecific low back pain that does not resolve with self-care and prompts patients to seek treatment in an ED may result from a serious underlying pathology. In this article, the first in a series on clinical red flags-indicators that can be used in the clinical setting to screen for an elevated risk of severe underlying conditions-the author considers back pain manifestations that may signal the presence of a debilitating or even fatal disease process. Detecting such red flags and communicating their presence to the attending provider can facilitate appropriate diagnosis and management. Read More

Braz J Phys Ther 2021 May 24. Epub 2021 May 24.

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark; Chiropractic Knowledge Hub, Odense M, Denmark.

Background: A paradigm shift away from clinician-led management of people with chronic disorders to people playing a key role in their own care has been advocated. At the same time, good health is recognised as the ability to adapt to changing life circumstances and to self-manage. Under this paradigm, successful management of persistent back pain is not mainly about clinicians diagnosing and curing patients, but rather about a partnership where clinicians help individuals live good lives despite back pain. Read More

J Neurosurg Spine 2021 Jun 11:1-8. Epub 2021 Jun 11.

1Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and.

Objective: Several studies have examined the relationship between sagittal spinopelvic alignment and clinical outcomes after spinal surgery. However, the long-term reciprocal changes in sagittal spinopelvic alignment in patients with lumbar spinal stenosis after decompression surgery remain unclear. The aim of this study was to investigate radiographic changes in sagittal spinopelvic alignment and clinical outcomes at the 2-year and 5-year follow-ups after minimally invasive lumbar decompression surgery. Read More