Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain
OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied pros...
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Veröffentlicht in: | Annals of the rheumatic diseases 1995-02, Vol.54 (2), p.100-106 |
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description | OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls. RESULTS--All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain. CONCLUSION--Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain. |
doi_str_mv | 10.1136/ard.54.2.100 |
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METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls. RESULTS--All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain. CONCLUSION--Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain.</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/ard.54.2.100</identifier><identifier>PMID: 7702395</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><subject>Aged ; Australia - epidemiology ; Biological and medical sciences ; Bupivacaine - administration & dosage ; Diagnosis, Differential ; Diseases of the osteoarticular system ; Diseases of the spine ; Female ; Humans ; Injections, Intra-Articular ; Low Back Pain - drug therapy ; Low Back Pain - epidemiology ; Low Back Pain - etiology ; Lumbar Vertebrae ; Male ; Medical sciences ; Middle Aged ; Prevalence ; Prospective Studies ; Spinal Diseases - complications ; Spinal Diseases - diagnosis ; Spinal Diseases - epidemiology</subject><ispartof>Annals of the rheumatic diseases, 1995-02, Vol.54 (2), p.100-106</ispartof><rights>1995 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Feb 1995</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b506t-609f6b6639e61d5e2500e42c473f0fa8d5dbb1a88aa8a310a39e1daefa86b3fc3</citedby><cites>FETCH-LOGICAL-b506t-609f6b6639e61d5e2500e42c473f0fa8d5dbb1a88aa8a310a39e1daefa86b3fc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005530/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005530/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3396153$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7702395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwarzer, A C</creatorcontrib><creatorcontrib>Wang, S C</creatorcontrib><creatorcontrib>Bogduk, N</creatorcontrib><creatorcontrib>McNaught, P J</creatorcontrib><creatorcontrib>Laurent, R</creatorcontrib><title>Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls. RESULTS--All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain. CONCLUSION--Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain.</description><subject>Aged</subject><subject>Australia - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine - administration & dosage</subject><subject>Diagnosis, Differential</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the spine</subject><subject>Female</subject><subject>Humans</subject><subject>Injections, Intra-Articular</subject><subject>Low Back Pain - drug therapy</subject><subject>Low Back Pain - epidemiology</subject><subject>Low Back Pain - etiology</subject><subject>Lumbar Vertebrae</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Spinal Diseases - complications</subject><subject>Spinal Diseases - diagnosis</subject><subject>Spinal Diseases - epidemiology</subject><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kcFv0zAYxS0EGqVw44pkCQQXUuw4thMOSKNiG9IEkxiIm_XFcVZ3iR3sZKNc-cdxaVUBB07-rPf7np79EHpMyYJSJl5BaBa8WOQLSsgdNKOFKLOcCHIXzQghLCsqIe-jBzGu05WUtDxCR1KSnFV8hn5eBHMDnXHaYHAN1p11VkOHWwPjFEzEvsXd1NcQ8I_NFQx-WG2iTcDaWzfiAax7jQHHcWo22Lpkgo-nOAbobBoTPnUwWu_wrR1XWK-CT_6487e4Bn39e_8hutdCF82j_TlHn0_eXS7PsvOPp--Xx-dZzYkYM0GqVtRCsMoI2nCTc0JMketCspa0UDa8qWsKZQlQAqMEEkgbMEkSNWs1m6M3O99hqnvTaOO2MdUQbA9hozxY9bfi7Epd-RuVPpZzRpLB871B8N8mE0fV26hN14EzfopKypxQWrAEPv0HXPspuPQ4RaWoJOMiVTdHL3eUDj7GYNpDFErUtlqVqlW8UPk2QcKf_Bn_AO-7TPqzvQ4xNdgGcNrGA8ZYJSjfZst2mI2j-X6QIVwrIZnk6sOXpXr79eLs5PTyk5KJf7Hj6379_4C_AN71yus</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>Schwarzer, A C</creator><creator>Wang, S C</creator><creator>Bogduk, N</creator><creator>McNaught, P J</creator><creator>Laurent, R</creator><general>BMJ Publishing Group Ltd and European League Against Rheumatism</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19950201</creationdate><title>Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain</title><author>Schwarzer, A C ; Wang, S C ; Bogduk, N ; McNaught, P J ; Laurent, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b506t-609f6b6639e61d5e2500e42c473f0fa8d5dbb1a88aa8a310a39e1daefa86b3fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Australia - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine - administration & dosage</topic><topic>Diagnosis, Differential</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the spine</topic><topic>Female</topic><topic>Humans</topic><topic>Injections, Intra-Articular</topic><topic>Low Back Pain - drug therapy</topic><topic>Low Back Pain - epidemiology</topic><topic>Low Back Pain - etiology</topic><topic>Lumbar Vertebrae</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Spinal Diseases - complications</topic><topic>Spinal Diseases - diagnosis</topic><topic>Spinal Diseases - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwarzer, A C</creatorcontrib><creatorcontrib>Wang, S C</creatorcontrib><creatorcontrib>Bogduk, N</creatorcontrib><creatorcontrib>McNaught, P J</creatorcontrib><creatorcontrib>Laurent, R</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwarzer, A C</au><au>Wang, S C</au><au>Bogduk, N</au><au>McNaught, P J</au><au>Laurent, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>54</volume><issue>2</issue><spage>100</spage><epage>106</epage><pages>100-106</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls. RESULTS--All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain. CONCLUSION--Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><pmid>7702395</pmid><doi>10.1136/ard.54.2.100</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Australia - epidemiology Biological and medical sciences Bupivacaine - administration & dosage Diagnosis, Differential Diseases of the osteoarticular system Diseases of the spine Female Humans Injections, Intra-Articular Low Back Pain - drug therapy Low Back Pain - epidemiology Low Back Pain - etiology Lumbar Vertebrae Male Medical sciences Middle Aged Prevalence Prospective Studies Spinal Diseases - complications Spinal Diseases - diagnosis Spinal Diseases - epidemiology |
title | Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain |
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