No abstract

No abstract

The McKenzie assessment process reliably differentiated discogenic from nondiscogenic pain (P < 0.001) as well as competent from an incompetent anulus (P < 0.042) in symptomatic discs and was superior to magnetic resonance imaging in distinguishing painful from nonpainful discs.

Objective: This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Low Back Disorders Guideline reviews the evidence and recommendations developed for non-invasive and minimally invasive management of low back disorders. Methods: Systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking. A total of 70 high-quality and 564 moderate-quality trials were identified for non-invasive low back disorders. Detailed algorithms were developed. Results: Guidance has been developed for the management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 121 specific recommendations. Conclusion: Quality evidence should guide treatment for all phases of managing low back disorders.

No abstract

Recurrent LBP episodes were common and numerous. Recurrences often worsened over time. It seems inappropriate to characterize the typical course of LBP as benign and favorable.

No abstract

In patients with low-back and radiating leg pain, a clinical phenomenon has been described known as "centralization," which occurs during a mechanical evaluation protocol described by McKenzie. Relocation of the most distal pain in a proximal or central direction characterizes the pain behavior when patients are assessed in this fashion.