An algorithmic approach for clinical management of low back pain

Chandra, Varun; Prasad, B. C. M.; Mohan, C Krishna; Kalawat, Tekchand; Satyanarayana, V.; Lakshmi, AY

doi:10.4103/0028-3886.190252

Cited by 4 publications

(19 citation statements)

References 2 publications

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“…Guidelines also lacked a description of the funding bodies and their influence on the content of the guideline and competing interests development group [21–42]. Over half of the guidelines had major limitations with systematic search methods used for evidence, criteria of selecting evidence and adequate descriptions of the strengths and limitations of the body of evidence [21, 22, 25, 26, 29, 31, 32, 34–37, 39, 42–50]. The methods for formulating the recommendations in these guidelines were often not described along with a (lack of) link given to the supporting evidence.…”

Section: Resultsmentioning

confidence: 99%

“…All the guidelines were authored by physician groups. Three lead authors authored all the included interventional pain guidelines (Easa [28]; Boswell [47, 48]; Manchikanti [19, 49, 50, 66–69]). All failed to outline barriers and facilitators to implementation, strategies to improve uptake and resource implications of applying the guideline with the exception of one [19].…”

Section: Invasive Techniquesmentioning

confidence: 99%

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Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review

Parikh

Santaguida

MacDermid

et al. 2019

BMC Musculoskelet Disord

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Background Neck pain (NP) is a very common musculoskeletal condition with potential for a high burden in disability and length of disorder. Clinical practice guidelines (CPG) give recommendations to clinicians for providing optimal care for patients however best practice recommendations are often contradictory. The purpose for this review was to conduct a SR of CPGs to assess the management recommendations for NP (diagnosis, treatment, prognosis, imaging). Methods Standard SR methodology was employed including a grey literature search (including the National Guideline Clearing House). Medline, Cinahl, Embase, ILC, Cochrane, Central, and Lilacs were searched from 1995-to March 2018. Two raters evaluated all citations and a third rater resolved any disagreements. The AGREE II was used to assess risk of bias of each CPG. Data was extracted and included CPG purpose, type of NP problem and clinical recommendations. The AGREE II critical appraisal tool was used to assess risk of bias of each CPG. Results From 640 articles, 241 were available for screening. A total of 46 guidelines were selected. CPG’s were categorized by the NP population (General NP, whiplash, interventional, headache and risk for vertebral insufficiency) and type of clinical aim (diagnosis, prognosis, treatment, imaging). Each clinical NP population had a large overlap of clinical aims presented. The CPGs were directed to a variety of clinicians that included physicians, physiotherapists and chiropractors. Results suggest heterogeneity in CPG recommendations within each clinical aim. CPG characteristics accounting for these differences are outlined. Conclusion The majority of CPGs were developed for general NP that focused on treatment recommendations, with fewer number aimed at recommendations for diagnosis, prognosis, and outcomes. Heterogeneity of recommendations within the categories were noted as were potential factors associated with these differences, including CPG quality as assessed by the AGREE II. Electronic supplementary material The online version of this article (10.1186/s12891-019-2441-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Invasive Techniquesmentioning

confidence: 99%

Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review

Parikh

Santaguida

MacDermid

et al. 2019

BMC Musculoskelet Disord

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“…The first study was published in 2003. 21 Sixteen studies were prospective, [21][22][23][24][25][26][27][28][29][31][32][33]47,48,51,56 20 were retrospective, 12,30,[34][35][36][37][38][39][40][41][42][43][44][45]49,50,[52][53][54][55] and 1 was a randomized controlled trial. 46 The sample size of the included studies ranged from 12 to 3900 subjects, all with a primary diagnosis of chronic low back pain.…”

Section: Overview Of the Selected Studiesmentioning

confidence: 99%

“…21,32,[34][35][36][37]39,41,50,52,55 The sample sizes for 11 of the 37 studies were <50 subjects. 21,23,[30][31][32][33]37,41,46,51,54 Each study was assigned a total score based on the number of acceptable items. The highest possible score was 10 or 11, depending on whether the study included MRI scans.…”

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

“…The highest possible score was 10 or 11, depending on whether the study included MRI scans. Five studies earned a total score of 11, 34,39,50,52,55 22 earned a score of 10, 12,22,[24][25][26]28,29,32,[34][35][36][37][38][40][41][42][43][44][47][48][49]53,56 8 earned a score of 9, 23,27,30,31,45,46,51,54 and 2 earned a score of 8. 21,33…”

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

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Predictors of Outcomes Following Lumbar Intra-articular Facet Joint Injections and Medial Branch Blocks

Acosta Julbe,

Mandell,

Ermann

et al. 2023

Spine

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Study design: A scoping review. Objective: We aimed to identify and describe the factors associated with the patient-reported response following lumbar intra-articular facet joint injections or medial branch blocks. Summary of Background Data: Facet joint osteoarthritis is among the most common causes of chronic low back pain. Management often includes facet joint intra-articular injection and medial branch blocks (which may be followed by radiofrequency ablation of the nerves innervating these joints). However, the success of these approaches is variable, prompting interest in identifying patient characteristics (imaging features, clinical signs, among others) associated with response to these types of facet injections. Methods: We performed a literature search on factors associated with patient-reported outcomes following lumbar facet joint intra-articular injections or medial branch blocks for patients with low back pain published in English or Spanish between 2000 and 2023. We excluded duplicates, papers that did not describe factors associated with outcomes, or those describing other interventions. We collected data on the association of these factors with patient-reported outcomes. Results: Thirty-seven studies met the inclusion criteria and were analyzed. These studies evaluated factors such as age, depression, and single-photon emission computed tomography (SPECT), among variables. Age and imaging findings of facet arthropathy were the most frequently described factors. Imaging findings of facet joint arthropathy and positive SPECT were often associated with positive results following intra-articular facet joint injections or medial branch blocks. In contrast, younger age and smoking were frequently associated with less favorable clinical outcomes. Conclusion: A myriad of factors were analyzed in the thirty-seven studies included in this review. Imaging findings of facet arthropathy, duration of pain, and positive SPECT were consistently associated with favorable results following facet interventions. Future prospective studies should include control groups. Clinicians may find these results useful in deciding whether to recommend facet injections.

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The outcomes of intra-articular corticosteroid injection into sacroiliac joint following findings of single-photon emission computed tomography imaging: a retrospective case series

2023

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An algorithmic approach for clinical management of low back pain

Cited by 4 publications

References 2 publications

Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review

Comparison of CPG’s for the diagnosis, prognosis and management of non-specific neck pain: a systematic review

Predictors of Outcomes Following Lumbar Intra-articular Facet Joint Injections and Medial Branch Blocks

The outcomes of intra-articular corticosteroid injection into sacroiliac joint following findings of single-photon emission computed tomography imaging: a retrospective case series

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