Active clinical trials for "Back Pain"

Low back pain (LBP) is the leading cause of disability and one of the most common reasons for physician visits in primary care, with a 33 % rate of recurrence during the first year, converting LBP into a chronic condition. The french High healthy authority recommend early occupational oriented intervention associated with a multidisciplinary rehabilitation program. However even if these recommendations are taken into appropriate account, risk for recurrence of Low back pain and occupational repercussions often occured. This study aims to identify the risk factor(s) of sick leave after a rehabilitation stay in outpatients and thus adapt cares provided to the patients in respect of their needs and expectations.

In this protocol, "Brain imaging biomarkers for response to Spinal Cord Stimulation in patients with chronic low back pain," the investigators plan to perform brain mapping studies in 42 patients who are undergoing spinal cord stimulation (SCS) for chronic low back pain (CLBP) as part of the participants normal clinical care during a 2-year period. This imagining study is completed for research purposes. There is no standard of care imaging for the participants. This study requires two visits in total. During the baseline visit, participants will undergo imaging acquisition protocol and corresponding assessments. Participants will have another follow-up visit (potentially remotely) for final assessments two weeks after the SCS treatment. The objective of the study is to investigate potential imaging biomarkers that can predict response to the SCS treatment. Specifically, the investigators hypothesize that the connectivity of a certain region of the brain (specifically the subgenual cingulate) prior to SCS may serve as a possible pre-operative imaging-based biomarker on response to SCS. The findings of the study may further enhance investigators understanding of the connectivity between brain areas that are critical to the therapeutic response to SCS in CLBP patients and that can be used as a putative biomarker to select patients who may respond to SCS.

Almost everyone will have low back pain (LBP) at some point in their lives. LBP is a complex multifactorial condition for which diagnosis and clinical management remains a challenge. Factors such as wait times, delays in diagnosis or proper referral can result in Canadian patients having difficulty getting the care that they need. The overall objective of this project is to explore how chiropractors, who specialize in the diagnosis and clinical management of spinal conditions, can transform healthcare trajectories and improve the health of patients with LBP by integrating medical specialist team.To do so, patients with low back pain seeking medical care within the public health system will be first seen by chiropractors. Chiropractors will play a key role in identifying the type of low back pain and subsequently offering guidance to medical specialists with regard to the best treatment and management options that are currently recommended. Participating patients will be followed over a year while extensive health-related data will be collected and compared to non-triage patients with LBP.

In the present study the investigators aim to examine the presence of bacteria in the disc and Modic Changes (MCs) (bone). A prospective study with 1-year follow-up of two patient populations undergoing elective spinal surgery (spinal fusion or disc herniation surgery) will be conducted. Patients previously operated on at index level will also be included, and evaluated as sub-groups. The following tissues are collected: dermis, sub-fascial tissue, nucleus pulposus, annulus fibrosus, and endplates. Endplate biopsies are only performed in patients undergoing fusion surgery. All tissue samples undergoing culturing should be processed within 4 hours of sampling. The time for sampling and culture processing are noted for each sample.In short, 1 mL enrichment broth (Brain Heart Infusion, BHI) is added to each tissue sample and further homogenized using sterile beads or a mortar. In addition, a control sample containing only enrichment broth is included. The control sample also undergoes the homogenization step. Each sample is plated onto three agar plates: blood and chocolate for aerobic culturing and anaerobic medium (HM0 or FAA) anaerobic culturing. The blood and chocolate agar plates and the enrichment broth are incubated in 35oC (5% CO2) and the anaerobic plates are incubated anaerobically for a total of 14 days. On day 3 and 7, the enrichment broth is plated onto a chocolate and an anaerobic agar for aerobic and anaerobic incubation respectively. Aerobic plates are read every 1-2 days and the anaerobic plates are read every 2-3 days. All growth is identified and recorded. Colonies considered relevant are frozen at -80oC. The pre-specification of microbiological results; significant growth, no growth and probable contamination (< 5 single colonies on primary plate and no growth from enrichement broth or no growth on primary plate, but growth from enrichement broth). Main endpoint for bacteriology is significant growth or no growth. A prespecification of PCR results in the probable contamination group seems to be premature, due to high risk of contamination. We will perform sensitivity analysis as the samples are analyzed, and PCR and histology will be used in combination to determine if a probable contamination should be considered in the significant growth group or in the no growth group. In addition to a pre-specified evaluation of growth or not, microbiologists and the pathologist are blinded to the knowledge of case or control. The clinicians are blinded to the results of aerob/anaerobe cultivation, PCR and histological report. Hence, the decision of no bacterial growth, probable contamination or significant growth cannot be influenced by information of case or control. Blood-samples are collected to characterize gene expression patterns and related markers to gain insight into molecular mechanisms that may be important for low back pain (LBP) and the development of MCs

To investigate whether different clinical, psychophysical and neurophysiological phenotypes can be identified among low back pain patients

Non-interventional, retrospective-prospective cohort study based on the collection of data and their evaluation after medical procedures: micro-discectomy, endoscopic discectomy, and hemilaminectomy.

Low back pain is one of the common problems that 80% of people experience at least once in their lifetime. Between 60% and 90% of the adult population are at risk for low back pain at some point in their lives. While most resolve within six weeks, relapses are common. Pain that lasts longer than 12 weeks is defined as chronic pain, and causes significant limitation in daily life and a high psychosocial burden due to pain. Chronic low back pain significantly limits occupational activities due to a decrease in functional status.

In recent studies, it has been shown that people may have avoidance of movement due to pain. However, there is no scale that evaluates avoidance of movement due to pain in musculoskeletal problems. The aim of this study is to develop a scale to measure how much pain-related movement and activity is avoided in individuals with musculoskeletal pain, and to examine the results of its clinical application.

This study aims to compare function of the body's endogenous pain modulation system between people with localized low back pain versus widespread body pain. Endogenous pain modulation refers to the body's natural ability to inhibit one pain stimulus by applying a second pain stimulus. This study will assess pain inhibition by measuring pressure pain thresholds at the low back before and during cold water hand immersion. The researchers hypothesize that those with widespread body pain will have worse functioning of pain inhibition compared to those with localized low back pain only. The results may provide insights into personalized chronic pain management approaches.

The purpose of this study is to assess the morphological changes in the lumbar multifidus, Erector spinae and Quadratus lumborum muscles and to investigate whether they are correlated with trunk extensor muscle strength in CNSLBP subjects. and to compare between these morphological changes during rest and contraction and to compare these results with control group. Twenty-nine subjects with CNSLBP and 29 age-matched healthy controls will be assessed by ultrasonography to detect the morphological changes of these muscles during rest and contraction ,and assessed strength of back extensors by hand-held dynamometer, and assessed functional disability by Arabic version of Oswestry disability index . They will be asked to sign the informed consent form.