Abstracts
Backache
Backache
Residents (64 men, 56 women) of a rural community in Sweden who were off work or had been examined by a physician because of acute low back/neck "pain" during a 1-year "period" were studied. The most common symptom was a dull ache (44%), mostly in the low back (56%).
In spite of early care, 16 patients who were randomly selected for further study developed chronic pain during the follow-up year. The patients with chronic pain did not differ from those without chronic pain in "age", amount of pain, or handicaps.
The risk of developing chronic pain, however, was nearly 5 times higher for those patients whose pain was provoked by trunk movements in several directions at the first clinical examination.
When signs of possible nerve root affection were present, the risk for chronic pain development was nearly 8 times higher. These results suggest that more attention may need to be paid to patients with these risk factors, so that preventive measures may be developed.
Hellsing, A.J., Linton, A.S., Kalvemark,M.: "A prospective study of patients with acute back and neck pain in Sweden." Phys. Ther. 1994 Feb; 74(2):116-24; discussion 125-8.
Breast Implantation
Breast Implantation
Attention has been drawn to elevated laboratory tests of inflammation as indicators of a possible reaction to silicone breast implants. These patients have complaints of joint pain, pain, and myalgia that were possibly caused by a reaction to silicone.
There were 74 out of 79 females with subjective complaints of upper extremity pain, joint pain, and aching. Forty-five of these patients had an identifiable diagnosis and 17 of them had elevation of at least one inflammatory indicator. Of the 74 female patients, 29 had no identifiable diagnosis and 21 of them had elevation of at least one inflammatory indicator.
In summary, there were a high number of female patients with complaints of upper extremity symptoms with no prior exposure to silicone from breast implantation. There was a statistically significant correlation in these patients who had no identifiable diagnosis and elevated indicators in inflammation. This suggests these markers of inflammation should not be used as indicators of a reaction to silicone from breast implantation in patients with upper extremity subjective complaints.
Kulick M & Daneshmand H: Breast implantation and the incidence of upper extremity somatic complaints. Aesthetic Plast Surg, 1997 Mar-Apr, 21:2, 105-9.
Fibromyalgia
Fibromyalgia
Fibromyalgia is a form of nonarticular rheumatism characterized by musculoskeletal aching and tenderness on palpation. The role of psychological factors in fibromyalgia has been controversial.
The aim of this study was to evaluate the relationship of fibromyalgia to the intensity of anxiety and depression and to determine the correlation between psychological disturbances with disease duration and pain severity.
Visual analog scale was used to determine pain intensity.
The difference in the psychological status between patients with fibromyalgia and control subjects as measured by Beck depression inventory and trait anxiety inventory was significant; 36% of the patients scored higher than the cut-off score on the Beck depression rating scale. Pain severity was found to be correlated with trait anxiety inventory scores.
Results suggest that somatic expression of depression is an important difference between fibromyalgia and control groups. The difference between state and trait anxiety inventory reflects that current anxiety is not secondary to pain but trait anxiety is possibly causally related to pain.
Celiker R et al., Psychological disturbance in fibromyalgia: relation to pain severity. Clin Rheumatol, 1997 Mar, 16:2, 179-84.
Pain or Disability
Pain or Disability
Low back disability needs to be distinguished from low "back pain". World-wide, the life-time history of low back pin ranged from 51 - 80%. In Holland, disability rates of 32% and 29% among men and women respectively have been reported in those with low back pain during a period of 18 months.
Throughout western society, low back disability among the working population has increased dramatically since the 1950's. However, no corresponding increase in the incidence of low back pain has been shown. Self employment is associated with a low risk of disability.
Little is known about low back disability among self-employed medical professionals, such as dentists, veterinarians, physicians and physical therapists.
The reported life-time history of low back pain among dentists in the US and Canada varies from 36% to 57%.
Introduction. Acta Orthop. Scand. (Supp.263) 1995; 66: 5 - 6.
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