Journal of Back and Musculoskeletal Rehabilitation - Volume 7, issue 2
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: This article presents an overview of psychological factors which influence chronic pain. Emphasis is placed on assessment techniques and psychological treatment approaches for patients with chronic pain. In the first section, the usefulness of psychometric measures are discussed and areas considered critical in the psychological assessment of chronic pain are reviewed, including (1) pain intensity, (2) functional capacity, (3) mood and personality, (4) pain beliefs and coping, (5) medication usage, (6) adverse effects, (7) behavioral analysis, and (8) health care utilization. Personality factors affecting pain syndromes, DSM-IV diagnoses and health care utilization issues are also discussed. In the second section,…an overview of psychological and behavioral interventions for chronic non-malignant pain are presented within the context of a multi-disciplinary pain management program. A rationale for a group-based program along with roles of a team, program goals, patient selection criterion, components of the program, and information on program evaluation is reviewed.
Abstract: Managed care continues to encroach upon virtually all health care delivery systems. Cost controls within these systems have been governed in the past by selection/deselection procedures and utilization management that are primarily based upon claims cost data. The recent movement toward integration of health care quality measures with financial data offers some hope that quality will not be unduly compromised in the efforts to control health care costs. In this new milieu there are increasing opportunities for health care professionals to participate in the development and refinement of managed care products. A model for a worker's compensation managed care system…being developed in Colorado is offered as an example of the movement toward more meaningful partnering between health care payers and providers.
Keywords: Managed care, Cost controls, Worker's compensation, Health care
Abstract: This is a review of local anesthetic (LA) injections and infiltrations particularly combined with ‘needling’ for management of local musculoskeletal pain. New techniques are described including preinjection blocks (PIBs) which consist of blocking the sensory input from an area prior to giving an injection. PIBs prevent pain which would be caused by needle penetration of sensitive tissue. Needling and infiltration (N and I) with 1% lidocaine has been performed after PIB in 179 tender spots (TSs), trigger points (TrPs), and muscle spasms by the author, in 123 patients with the goal to relieve pain and promote healing. The immediate effect…after the procedure as well as long-term results from 1 week to 7 months have been evaluated independently by a physiatrist experienced with injections (Dr. Tae Mo Chang). N and I extending over the entire taut band of abnormal muscle fibers, caused effective relief of pain and functional improvement in tender spots (TSs), trigger points (TrPs) and in muscle spasm caused by a variety of conditions including: acute and chronic sports and work injuries, motor vehicle accidents, muscle and ligament sprains (supraspinous, sacroiliac), overuse and repetitive stress syndromes, tennis elbow; local injuries or radicular irritation; and local inflammations such as bursitis, tendinitis, and osteoarthritis; and traumatic dystrophy, a type of reflex sympathetic dystrophy. Needling and infiltration of trigger areas and tender spots is effective treatment in several conditions. Pre-injection blocks allow the performance of the N and I of tender areas without pain.
Abstract: This paper focuses on the special aspects of pelvic pain that make it a difficult area in which to work. This will be done by use of specific examples of certain chronic pelvic pain conditions. This will be followed by a general discussion of current diagnosis and treatment methods for common pain syndromes. Most of these patients are women who suffer from pelvic pain. Case presentations will be used to illustrate the application of the materials presented. In the final analysis, diagnosis and management of chronic pelvic pain is best treated by an individual who is experienced, knowledgeable, and cognizant…of the intricate relationship between pain, organopathology and neuropathology.