Chiropractic treatment vs self-management in patients with acute chest pain: a randomized controlled trial of patients without acute coronary syndrome.

Objective: The musculoskeletal system is a common but often overlooked cause of chest pain. The purpose of the present study is to evaluate the relative effectiveness of 2 treatment approaches for acute musculoskeletal chest pain: (1) chiropractic treatment that included spinal manipulation and (2) self-management as an example of minimal intervention.

Methods: In a nonblinded, randomized, controlled trial set at an emergency cardiology department and 4 outpatient chiropractic clinics, 115 consecutive patients with acute chest pain and no clear medical diagnosis at initial presentation were included.

An educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP. A pragmatic, randomised trial with a one-year follow-up.

Background: In the treatment of chronic back pain, cognitive methods are attracting increased attention due to evidence of effectiveness similar to that of traditional therapies. The purpose of this study was to compare the effectiveness of performing a cognitive intervention based on a non-injury model with that of a symptom-based physical training method on the outcomes of low back pain (LBP), activity limitation, LBP attitudes (fear-avoidance beliefs and back beliefs), physical activity levels, sick leave, and quality of life, in chronic LBP patients.

Methods: The study was a pragmatic, single-blind, randomised, parallel-group trial.

No evidence for presence of bacteria in modic type I changes.

Background: Recent studies suggest an association between sciatica and Propionibacterium acnes. "Modic type I changes" in the vertebrae are closely associated with sciatica and lower back pain, and recent studies have questioned the ability of conventional magnetic resonance imaging (MRI) to differentiate between degenerative Modic type I changes and vertebral abnormalities caused by infection.

Purpose: To test whether bacteria could be cultured from biopsies of Modic type I changes.

Education of patients after whiplash injury: is oral advice any better than a pamphlet?

Study Design: Randomized parallel-group trial with 1-year follow-up.

Objective: To evaluate whether education of patients communicated orally by a specially trained nurse is superior to giving patients a pamphlet after a whiplash injury.

Summary Of Background Data: Long-lasting pain and physical disability after whiplash injuries are related to both serious personal suffering and huge socio-economic costs.

High-level physical activity in childhood seems to protect against low back pain in early adolescence.

Background: The evidence on the impact of physical activity on back pain in children and adolescents has been contradicting. It has also been shown that the physical activity cannot accurately be estimated in children using questionnaires.

Purpose: The aim of this study was to establish if physical activity in childhood had any impact on back pain reporting in early adolescence (3 years later), using an objective instrumental measurement of physical activity.

Are altered smooth pursuit eye movements related to chronic pain and disability following whiplash injuries? A prospective trial with one-year follow-up.

Objective: To evaluate the ability of early smooth pursuit testing to predict chronic whiplash-associated disorders, and to study whether the presence of abnormal smooth pursuit eye movements at one-year follow-up is associated with symptoms at that time.

Design: Prospective cohort study with one-year follow-up.

Setting: The study was carried out at a university research centre and participants were recruited from emergency units and general practitioners.

Better backs by better beds?

Study Design: A "randomized"/stratified, single-blinded, parallel-group study. OBJECTIVE.: To evaluate 3 structurally different mattresses relative influence on patients with chronic low back pain (CLBP).

Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial.

Background: Acute chest pain is a major health problem all over the western world. Active approaches are directed towards diagnosis and treatment of potentially life threatening conditions, especially acute coronary syndrome/ischemic heart disease. However, according to the literature, chest pain may also be due to a variety of extra-cardiac disorders including dysfunction of muscles and joints of the chest wall or the cervical and thoracic part of the spine.

Self-reported hard physical work combined with heavy smoking or overweight may result in so-called Modic changes.

Background: Recently, the MRI finding of "Modic changes" has been identified as pathologic spinal condition that probably reflects a vertebral inflammatory process (VIP), which coincides with spinal pain in most. We hypothesized that heavy smoking in combination with macro- or repeated microtrauma could lead to VIP. The objectives were to investigate if combinations of self-reported heavy smoking, hard physical work, and overweight would be more strongly linked with VIP than with other spinal conditions, such as degenerated discs and non-specific low back pain (LBP).

The effect of body position and axial load on spinal canal morphology: an MRI study of central spinal stenosis.

Study Design: A method comparison study.

Objective: To investigate the effect of body position and axial load of the lumbar spine on disc height, lumbar lordosis, and dural sac cross-sectional area (DCSA). SUMMARY OF BACKGROUND DATA.

Acute stress response and recovery after whiplash injuries. A one-year prospective study.

Chronic whiplash-associated disorder (WAD) represents a major medical and psycho-social problem. The typical symptomatology presented in WAD is to some extent similar to symptoms of post traumatic stress disorder. In this study we examined if the acute stress reaction following a whiplash injury predicted long-term sequelae.

Modic changes, possible causes and relation to low back pain.

Unlabelled: In patients with low back pain (LBP) it is only possible to diagnose a small proportion, (approximately 20%), on a patho-anatomical basis. Therefore, the identification of relevant LBP subgroups, preferably on a patho-anatomical basis, is strongly needed. Signal changes on MRI in the vertebral body marrow adjacent to the end plates also known as Modic changes (MC) are common in patients with LBP (18-58%) and is strongly associated with LBP.

Is active participation in specific sport activities linked with back pain?

A cross-sectional survey of 439 children/adolescents aged 12-13, living in Odense, Denmark, in the year 2001. To investigate (1) if there is any difference in back pain reporting among those practising specific sports as compared with non-performers and (2) if there is an association between specific kinds of sports and self-reported back problems. Back pain is a common complaint in young people and physical inactivity is generally thought to contribute to this.

Modic changes following lumbar disc herniation.

Only a small proportion (20%) of patients with LBP can be diagnosed based on a patho-anatomical entity. Therefore, the identification of relevant subgroups, preferably on a patoanatomical basis, is strongly needed. Modic changes have been described by several authors as being closely linked with LBP.

Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?

Background: Because training of the lumbar muscles is a commonly recommended intervention in low back pain (LBP), it is important to clarify whether lumbar muscle atrophy is related to LBP. Fat infiltration seems to be a late stage of muscular degeneration, and can be measured in a non-invasive manner using magnetic resonance imaging. The purpose of this study was to investigate if fat infiltration in the lumbar multifidus muscles (LMM) is associated with LBP in adults and adolescents.

Active lifestyle protects against incident low back pain in seniors: a population-based 2-year prospective study of 1387 Danish twins aged 70-100 years.

Study Design: Prospective cohort study of twins.

Objectives: To investigate associations between physical activity, physical function, and incident low back pain (LBP) in an elderly population.

Summary Of Background Data: The relationship between an active lifestyle and LBP in seniors is unknown.

Manual examination of the spine: a systematic critical literature review of reproducibility.

Objective: Poor reproducibility of spinal palpation has been reported in previously published literature, and authors of recent reviews have posted criticism on study quality. This article critically analyzes the literature pertaining to the inter- and intraobserver reproducibility of spinal palpation to investigate the consistency of study results and assess the level of evidence for reproducibility.

Methods: Systematic review and meta-analysis were performed on relevant literature published from 1965 to 2005, identified using the electronic databases MEDLINE, MANTIS, and CINAHL and checking of reference lists.

Modic changes and their associations with clinical findings.

It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all.

Coping and back problems: analysis of multiple data sources on an entire cross-sectional cohort of Swedish military recruits.

Background: As the literature now stands, a bewildering number and variety of biological, psychological and social factors are, apparently, implicated in back problems. However, if and how these have a direct influence on back problems is not clear. Obesity, for example, has in many studies been shown to be associated with back problems but there is no evidence for a causal link.

Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population.

Background: It has previously been shown that low back pain (LBP) often presents already in the teenage years and that previous LBP predicts future LBP. It is also well documented that there is a large degree of comorbidity associated with LBP, both in adolescents and adults. The objective of this study is to gain a deeper insight into the etiology of low back pain and to possibly develop a tool for early identification of high-risk groups.