N Bogduk

..Experiments in normal volunteers have established that the cervical muscles and joints can be sources of headache...

..Forthcoming reviews draw on this information to explain how injuries might occur in situations where hitherto it was believed that no injury was possible, or that no evidence of injury could be detected...

..This nosologic entity has survived challenge with placebo-controlled, diagnostic investigations and has proven to be of major clinical importance...

..A secondary aim is to determine if pain severity, level of disability and fear of movement/(re)injury predict response to a physical activity program...

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..Positive blocks also predict good outcome from radiofrequency neurotomy of the nerve blocked...

..On the basis of observational data, intradiscal electrothermal anuloplasty (IDETA) has been implemented as a treatment for back pain resulting from internal disc disruption...

..Zygapophysial joint pain can be relieved by radiofrequency neurotomy; techniques are emerging for treating sacroiliac joint pain and internal disc disruption...

..They can also confirm or refute purported mechanisms of certain clinical features in complex regional pain syndromes...

..Ironically, for chronic low back pain, the most effective and long-lasting outcomes have been documented for normal saline by injection into tender points in the lumbar spine...

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..CONCLUSIONS. The zygapophysial joint is an important source of pain but the existence of a "facet syndrome" must be questioned...

..CONCLUSION. The sacroiliac joint is a significant source of pain in patients with chronic low back pain and warrants further study...

..CONCLUSIONS. The SCL-90-R is a convenient instrument to administer to patients with whiplash. It yielded a characteristic profile of pain and appears to be more expedient than other psychometric tests for these patients...

..However, if increases in passive tension are considered it emerges that the compression forces and moments exerted by the back muscles in full flexion are not significantly different from those produced in the upright posture...

..The high yield of positive responders in this study probably reflects the propensity of patients with zygapophysial joint syndromes to gravitate to a pain clinic when this condition is not recognised in conventional clinical practice...

..CONCLUSIONS. Computed tomography has no place in the diagnosis of lumbar zygapophysial joint pain...

..Painful joints were identified in 54% of the patients (95% confidence interval, 40% to 68%). CONCLUSION. In this population, cervical zygapophysial joint pain was the most common source of chronic neck pain after whiplash...

..Consumers approve of evidence-based care...

..Only three patients had both a positive discogram and a symptomatic zygapophyseal joint. CONCLUSIONS. In patients with chronic low back pain, the combination of discogenic pain and zygapophyseal joint pain is uncommon...

..Although the relief of headache is limited in duration, it is profound and can be reinstated by repeat neurotomy. No other form of treatment has been validated for this common form of headache...

..The definitive criterion is complete relief of pain after controlled diagnostic blocks of cervical structures or their nerve supply. The most rigorously studied example of cervicogenic headache is third occipital headache...

..As a result, negative conclusions about procedures have been drawn because lack of efficacy of one procedure has been misattributed to other, cognate, but different procedures...

..To describe and test a model to explain the biomechanical basis for persistent pain after compression fractures of the vertebral body...

..It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP...

..Although guidelines for the management of low back pain have been promoted, few studies have assessed their effectiveness. One previous study did not include patients with workers' compensation claims...

..A force coefficient of 46 Ncm-2 was determined to apply for the back muscles. These results have a bearing on the appreciation of the effects on the back muscles of surgery and physiotherapy...

..However, the study indicated that its results should be reproduced before they could be generalized...

..This result vindicates the technique used to plot the location of individual fascicles of the lumbar back muscles...

..These equations allow aberrations in the location of an axis to be interpreted in terms of the anatomical and pathological factors that affect the centre of reaction of the vertebra and the rotation and translation it undergoes...

..They provide an example and benchmark for how diagnostic blocks can and should be validated...

..However, the changes in probability are usually small and at best moderate. The usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear...

..These data indicate that quadratus lumborum has no more than a modest action on the lumbar spine, in quantitative terms. Its actual role in spinal biomechanics has still to be determined...

..We provide recommendations that enable a pragmatic approach to the diagnosis and management of probable cervicogenic headache, as well as a rigorous approach to the diagnosis and management of definite cervical headache...

..The critique of many of the accepted entities in the differential diagnosis of neck pain is crucial to an understanding of the causes of neck pain and an ability to implement appropriate therapies...

..Other techniques lack such a basis, and have not been vindicated clinically. Suboptimal techniques may underlie suboptimal outcomes from lumbar medial branch neurotomy...

..A retrospective, cohort study of the kinematics of the lumbar spine of patients with spondylolisthesis compared with asymptomatic normal subjects...

..To summarize and to analyze the available literature on the efficacy of intra-articular injections of corticosteroids for low back pain...

..To compare the safety and effectiveness of minimal access posterior lumbar interbody fusion (MAPLIF) with open posterior lumbar interbody fusion (OPLIF) in patients with spondylolisthesis and radicular pain...

..quot; None of these studies, however, controlled for both pressure of injection and intensity of response...

..Cohort study...

..In this chapter the evidence for efficacy and safety is reviewed and interrogated with special emphasis on the available randomized controlled trails and systematic review...

..To determine the patterns of referred pain in patients with proven cervical zygapophysial joint pain...

..Occasionally, long-term treatment with medication may be indicated. Anterior cervical diskectomy and fusion is necessary on rare occasions...

..In the short-term exercise and advice is slightly more effective than advice alone for people with persisting pain and disability following whiplash. Exercise is more effective for subjects with higher baseline pain and disability...

..To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain...

..To determine the prevalence of different causes of neck pain in a private practice clinic...

..The practice of epidural injections is dissonant both with the evidence-based literature and with recommended guidelines, and squanders both financial and professional resources...

..Importantly, the findings of this study emphasize the need for clinical and biomechanical literature to portray the gross anatomy of ligamentum nuchae accurately...

..Diagnostic blocks of nerves supplying the joints are performed using fluoroscopy. The authors' hypothesis was that the third occipital nerve can be visualized and blocked with use of an ultrasound-guided technique...

..Therefore, a study was designed to determine whether there is a basis for promoting a theoretically safer nonparticulate corticosteroid preparation...

..Intradiscal electrothermal therapy (IDET) is a treatment for discogenic low back pain the efficacy of which has not been rigorously tested...