Active clinical trials for "Low Back Pain"

The main purpose of this study is to assess the clinical efficiency of an intervention including a short multidisciplinary program of education and rehabilitation and a personalized follow-up, in patients with subacute and chronic low back pain and no severe disability. The secondary objectives are: to assess the capacity of the program to modify and reduce the risk factors for evolution of patients towards a severe disability, to estimate the cost-utility ratio of the intervention.

The investigators will learn from the study whether actors playing the roles of patients (standardized patients) can help primary care and urgent care clinicians develop skill in offering watchful waiting to patients with acute low back pain as a means of averting low-value spinal imaging. Using patient and physician feedback, this study will refine and evaluate -- in a controlled experiment -- a simulated standardized patient intervention to enhance primary care physician use of watchful waiting when patients request low-value spinal imaging. The long-term goal of this study is to discover communication strategies primary care physicians can use to avert costly, potentially harmful testing while maintaining the patient-doctor relationship.

Over the last years a rising medical need for treatment of chronic pain was identified. Based on previous findings indicating the pain modulating effects of cannabinoids in chronic pain disorders, this clinical trial investigates the efficacy and tolerability of the THC-focused nano endocannabinoid system modulator AP707 in patients with chronic back pain disorders. Patients receive AP707 or placebo over the course of 14 weeks as an add-on to the standard of care. Changes in pain intensity, quality of life and sleep and others measures are monitored through different scales to assess the efficacy of AP707 in patients with chronic back pain.

The objective of this study will be to identify the short-term impact of positive, neutral, or negative speech on pain intensity (primary outcome). The secondary outcomes assessed will be the global perceived effect of improvement, patient's expectations regarding spinal manipulative therapy (SMT) intervention, and perception of empathy in the therapeutic encounter in patients with chronic low back pain (CLBP). This study will enroll 60 participants with CLBP aged between 18 and 60 years. This is an exploratory randomized clinical trial. The three groups will receive a manual therapy session after watching the video proposed for their group. First participants will be assessed for pain intensity, low back pain disability, psychosocial aspects, and expectations related to treatment. Secondly, a researcher not involved in the recruitment of patients will randomly allocate the participants into three different groups (G1- group submitted to positive expectation, G2- group submitted to neutral expectation, and G3- group submitted to negative expectation). After the allocation, the participants will watch a short video (no more than 3 minutes) delivering positive, negative, or neutral messages regarding SMT. And finally, a physiotherapist will administer one session of SMT and participants will be re-assessed to investigate the immediate effect of the videos on the pain intensity, global perceived effect of improvement, and expectations. Ultimately, patients will be submitted to a semi-structured interview in which their perceptions about the videos will be investigated. Outcomes will be assessed just immediately after one SMT session.

The purpose of the current study is to determine the effect of myofascial release of plantar fascia on pain, back function, lumbar flexibility and pain pressure threshold for patients with CNSLBP.

The goal of this observational trial is to compare the health history and motion capabilities of participants with low back pain disorders to participants with healthy spines. The main question[s] it aims to answer are to: Primary outcomes of this research effort include composite measures that differentiate between control and patient populations, predict injury or reinjury risk, identify low back and neck pain patient phenotypes, and evaluate treatment effectiveness. Secondary outcomes of this research effort include an assessment of wearable motion sensor accuracy, characterization of motion assessment utility, biopsychosocial profiling of control and low back and neck pain patient populations, and differentiation of sincere and insincere motion assessment efforts. Participants will complete questionnaires and wear a motion monitor that will assess your back and/or neck. This session will be approximately 40-70 minutes. The research team will follow up with participants at 3 month, 6 months, 1 year, 2 years, 5 years to complete a short series of questionnaires and a motion assessment test.

This study relies on the use of a smartphone application (SOMA) that the investigators developed for tracking daily mood, pain, and activity status in acute pain, chronic pain, and healthy controls over four months.The primary goal of the study is to use fluctuations in daily self-reported symptoms to identify computational predictors of acute-chronic pain transition, pain recovery, and/or chronic pain maintenance or flareups. The general study will include anyone with current acute or chronic pain, while a smaller sub-study will use a subset of patients from the chronic pain group who have been diagnosed with chronic low back pain, failed back surgery syndrome, or fibromyalgia. These sub-study participants will first take part in one in-person EEG testing session while completing simple interoception and reinforcement learning tasks and then begin daily use of the SOMA app. Electrophysiologic and behavioral data from the EEG testing session will be used to determine predictors of treatment response in the sub-study.

When the thoracic kyphosis and lumbar lordosis are within a normal range of angular values back pain is less likely to occur. Angular modifications in the physiological curvatures of this sagittal plane have been shown to indicate spinal disorders. For instance, increasing lumbar lordosis and thoracic kyphosis result in higher intradiscal pressure, tension in the spine's passive parts, and creep in the lumbar viscoelastic structures. One of the most important factors of human biomechanics, spinal curvatures provide optimal energy expenditure and movement capacity. Abnormal adaptations in thoracic and lumbar spine biomechanics can cause low back and back pain. Multiple spinal segments are covered by the lumbar erector spinae muscle (LES), which is regarded as a superficial back muscle. LES consists of two muscles, the longissimus thoracis and iliocostalis lumborum. To move the lumbar spine, the lumbar erector spinae muscle (LES) is recruited in a manner that depends on the applied force. It was suggested that patients used LES to compensate for laxity in passive ligamentous structures in an attempt to reduce excessive force on the lumbar spine. Excessive lumbopelvic movements and altered muscle activation patterns are common in patients with low back pain. Researchers have investigated the timing of each muscle's onset and the activity of the LES, and found that patients with low back pain had higher LES activation compared to healthy people. Exercises for strengthening the LES muscle have been performed trunk extension during prone position. Strenghening LES and thoracic extansors may lead to decrease or prevent painful spinal disorders, improve thoracic excessive kyphosis and other complications. Prone trunk extension exercises is used to clinically exercise approcah to activate weak and susceptible to fatigue LES muscle in patients with nonspecific low back pain. This exercise lead to not only strentghening but also lengthening and streching these muscles. To fully understand the effects and underliying the mechanism of this exercise, biomechanical changes in lumbopelvic movement patterns of individuals with kyphotic posture should be examined. Based on current evidence, it is not clear the mechanism that the prone trunk extension exercises is effective on different spinal alignment postures as excessive thoracic khyposis and compansation mechanism on lumbal lordosis. Thus findings from this research may guide clinicians to examine the effects of different prone trunk extension exercises on LES muscles activation. Mitani et al showed that different upper extremity postures effects the lumbal multifudis activations during standing. Brown et al indicated that sit-stand workstations do not change muscle activations of lumbar muscles. Muyor et al concluded that spinal aligment of cyclists affects core muscle activity during cyling. Wattananon et al demonstrated that clinicians should focus on muscle activation patterns rather than the amount of lumbopelvic motion during prone hip extension. Based on the current studies, and to optimally address the underlying mechanism that the main objective was to investigate and show the effects of lumbal lordosis and thoracic kyphosis angles on muscle activations during different low back exercises.

The study aims to identify metabolites present in intervertebral discs colonized by C. acnes from patients with low back pain and degenerative disc disease, correlating them with their clinical, radiological and demographic profiles.

Low back pain is a major health problem that affects psychosocial, economical, functional and physical aspects of the patients' life. The aim of this study will be to investigate the effectiveness of dry needling on pain, functional disability, postural control and pain pressure threshold in patients with chronic nonspecific low back pain using a randomized controlled trial design. Patients with chronic nonspecific low back pain will be randomly divided into two groups: Experimental group (dry needling and routine physical therapy) and control group (sham dry needling and routine physical therapy). Primary outcomes will be pain intensity and functional disability. Postural control and pain pressure threshold will be considered as secondary outcomes.