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1

Leech, Clement. Preventing chronic disability from low back pain: Renaissance project. Dublin: Stationery Office, 2004.

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2

Chronic low back pain: Assessment and treatment from a behavioral rehabilitation perspective. Amsterdam: Swets & Zeitlinger, 1991.

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3

Adams, Nicola B. K. Psychophysiological and neurochemical substrates of chronic low back pain and modulation by treatment. [s.l: The Author], 1992.

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4

Vällfors, B. Acute, subacute and chronic low back pain: Clinical symptoms, absenteeism and working environment. Göteborg: [s. n., 1985.

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5

Allen, Sara Elizabeth. What is the evidence for the effectiveness of non-drug pain management on patients with chronic low back pain?. Oxford: Oxford Brookes University, 2002.

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6

Watson, Paul John. The function of the paraspinal muscles in chronic low back pain patients: A comparison of surface electromyography in normal, healthy control group and an evaluation of the effects of a pain management programme. Manchester: University of Manchester, 1995.

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7

Knezevic, Nebojsa Nick, Teresa M. Kusper, and Kenneth D. Candido. Chronic Low Back Pain in a Young Patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0023.

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Chronic low back pain (CLBP) in young adults is a great public health concern. CLBP affects individuals across all age groups with varying frequency, and it is associated with significant disability and morbidity, missed school or work, loss of productivity, and substantial health care expenditures. It can occur suddenly as a result of injury, or develop gradually due to degenerative changes in the spine. Correct diagnosis and proper management, usually involving a multidisciplinary approach, are paramount for optimal pain management. Usually, combinations of conservative management (pharmacologic and nonpharmacologic) with epidural steroid injections can achieve long-term pain relief and relapse prevention.
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8

Knezevic, Nebojsa Nick, Benjamin Cantu, Ivana Knezevic, and Kenneth D. Candido. Chronic Back Pain in the Elderly: Spinal Stenosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0022.

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Chronic low back pain (CLBP) is a common reason for physician office visits among the elderly. Predictive factors for CLBP are female sex, social isolation, hypertension, and joint pain. In the elderly, CLBP may be related to degenerative spinal stenosis with disk degeneration and overall spondylosis. A detailed medical history and a targeted, comprehensive physical examination are the initial approaches to rule out underlying disease that requires urgent attention. Clinical and evidence-based approaches to management suggest avoiding early MRI or CT, as imaging in elderly patients has proven both impractical and uneconomical. Instead, good clinical judgment should be used for making diagnoses. Consensus on the best initial approaches for managing CLBP has not yet been achieved, and conservative therapy is suggested, varying from use of pharmacologic agents, physical therapy, electrical stimulation, and physical manipulations to epidural injections. Surgical alternatives are avoided due to confounding and multiple comorbidities in older patients.
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9

Acute and chronic low back pain. York: NHS Centre for Reviews and Dissemination, University of York, in association with Royal Society of Medicine Press, 2000.

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10

Jain, Rakesh, and Shailesh Jain. Disability in chronic low back pain. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0076.

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The landmark paper discussed in this chapter, ‘Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability’, published by Crombez et al. in 1999, investigates the issue of disability in chronic low back pain and explores the role of psychological factors in disability. The paper reports on three independent chronic low back pain studies in which behavioural performance and the degree of reported disability were correlated with psychological factors such as catastrophization, negative affect, anxiety, and pain-related fear (e.g. fear of re-injury). In a counterintuitive finding, pain-related fear was more disabling that the pain itself. This paper thus highlighted the need to assess and address the psychological domains of pain; it also validated three questionnaires that are important in the pain field, and established a biopsychosocial approach to understanding, explaining, and treating chronic low back pain.
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11

D, Diwan Ashish, and Khan Safdar N, eds. Chronic low back pain: Issues and management. Philadelphia: Saunders, 2004.

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12

D, Diwan Ashish, and Khan Safdar N, eds. Chronic low back pain: Issues and management. Philadelphia: Saunders, 2004.

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13

Fairbank, Jeremy. Surgical management of chronic low back pain. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.003006.

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♦ A very small proportion of back pain patients respond to surgical treatment♦ Patient selection is poorly defined♦ The rationale of treatment ranges from immobilization (fusion) to claimed restoration of normal movement (disc replacement and flexible fixation).
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14

D, Diwan Ashish, and Khan Safdar N, eds. Chronic low back pain: Issues and management. Philadelphia: Saunders, 2003.

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15

D, Diwan Ashish, and Khan Safdar N, eds. Chronic low back pain: Issues and management, Part I. Philadelphia: W.B. Saunders Co., 2003.

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16

Martin, Josie Allen. THE MEANING OF CHRONIC LOW BACK PAIN: A PHENOMENOLOGICAL STUDY. 1989.

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17

O'Neill, Katherine M. The psychological management of chronic low back pain: A controlled trail. 1995.

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18

Backache Survival: The Holistic Medical Treatment Program for Chronic Low Back Pain. Tarcher, 2003.

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19

Elnaggar, Ibrahim Magdy. THE EFFECTS OF SPINAL FLEXION AND EXTENSION EXERCISES ON LOW BACK PAIN SEVERITY AND SPINAL MOBILITY IN CHRONIC MECHANICAL LOW BACK PAIN. 1988.

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20

Low Back Pain: An Historical and Contemporary Overview of the Occupational, Medical, and Psychosocial Issues of Chronic Back Pain. Slack, 1989.

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21

Chronic Diseases and Health Care: New Trends in Diabetes, Arthritis, Osteoporosis, Fibromyalgia, Low Back Pain, Cardiovascular Disease, and Cancer. Springer, 2006.

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22

Bogduk, Nikolai, and Brian McGuirk. Medical Management of Acute Chronic Low Back Pain: An Evidence-Based Approach (Pain Research and Clinical Management, V. 13). Elsevier Publishing Company, 2002.

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23

(Editor), Nikolai Bogduk, and Brian McGuirk (Editor), eds. Medical Management of Acute and Chronic Low Back Pain: Pain Research and Clinical Management Series, Volume 13 (Pain Research and Clinical Management). Elsevier, 2002.

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24

Lisanti, Phyllis A. PERCEIVED BODY SPACE AND SELF-ESTEEM IN ADULT MALES WITH AND WITHOUT CHRONIC LOW BACK PAIN. 1987.

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25

Kleppan, Glenn Stenholm. An investigation into the efficacy of a functional restoration programme including back school in patients with chronic low back pain. 1998.

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26

Fairbank, Jeremy, and Elaine Buchanan. Non-operative management of non-specific low back pain (types 1 and 2). Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.003004.

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♦ Back pain is common♦ Most attacks are self limiting♦ Exercise and fitness programmes seem to be the most effective intervention♦ CPP programmes are effective for chronic back pain and should be introduced early.
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27

Chronic Diseases and Health Care: New Trends in Diabetes, Arthritis, Osteoporosis, Fibromyalgia, Low Back Pain, Cardiovascular Disease, and Cancer. Springer, 2010.

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28

Coulter, Ian, Margaret Whitley, Eric Hurwitz, Howard Vernon, Paul Shekelle, and Patricia Herman. Determining the Appropriateness of Spinal Manipulation and Mobilization for Chronic Low Back Pain: Indications and Ratings by a Multidisciplinary Expert Panel. RAND Corporation, 2018. http://dx.doi.org/10.7249/rr2475.

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29

Goldby, Lucy. A randomised controlled trial comparing the McKenzie method of mechanical diagnosis and therapy with a non-prescriptiveexercise regime in the conservative treatment of chronic low back pain. UEL, 1994.

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30

Pederson, Siw Annick. A questionnaire investigating the use of exercise as a treatment modality in the management of chronic low back pain by senior physiotherapists in the Northwest region of England. 2003.

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31

Lavand’homme, Patricia, and Fabienne Roelants. Persistent pain after caesarean delivery and vaginal birth. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0025.

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Persistent pain after childbirth has recently received a lot of attention as potentially many women could be affected. Several pain syndromes including pelvic girdle pain, low back pain, and headaches occur during the pregnancy and can persist after delivery. The prevalence of chronic pain directly related to the delivery, at 6 months and later after childbirth, is however very low (< 2%) compared to chronic pain which occurs after other types of tissue trauma as in common surgical procedures. Acute pain is a major risk factor in the development of persistent pain after surgery and trauma. After childbirth, the severity of acute pain, independent of the mode of delivery (i.e. the degree of tissue damage) only predicts an increased risk of persistent pain (a 2.5-fold increase) at 2 months but not later. An individual’s pain response seems to be the most relevant factor in the development of persistent pain. In retrospective studies, patient-specific risk factors, such as a pre-existing chronic pain condition or pain elsewhere, were predictive factors. In prospective studies, the low incidence of persistent pain at 6 and 12 months make the analysis of risk factors unreliable.
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32

Pangarkar, Sanjog S. Pain and Addiction in Patients with Traumatic Brain Injury (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0027.

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Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
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33

Colameco, Stephen. Pain and Addiction in Patients with Co-Occurring Medical Disorders (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0026.

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Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
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34

Karan, Lori D. Pain and Addiction in Patients Who Smoke Cigarettes (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0029.

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Through a discussion of the effects of cigarette smoking on both pain perception and other substance use, this chapter outlines the presentation of the benefits to the patient and reviews smoking cessation strategies. It begins with an epidemiological review of the higher prevalence of smoking among those with chronic pain syndromes, such as fibromyalgia, headache, and low back pain. The many adverse consequences of cigarette smoking for general health are identified, from enhanced osteoporosis to prolonged wound repair. Most strikingly, smoking is demonstrated to both exacerbate the experience of pain and lead to a heightened requirement for opioid analgesia. Its overlap with other substance use disorders has long been recognized, including an association with higher relapse rates to alcohol and other drugs. A table is provided detailing the physiological improvements seen upon smoking cessation.
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35

Von Korff, Michael. Fear and depression as remediable causes of disability in common medical conditions in primary care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780198530343.003.0007.

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This chapter argues that psychological states, in particular fear and depression, are potentially remediable causes of social role disability among primary care patients. Using chronic low back pain as an example, it considers how recognising and treating depression can improve disability and quality of life for primary care patients with this and many other chronic conditions.
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36

Foorsov, Victor, Omar Dyara, Robert Bolash, and Bruce Vrooman. Sacroiliac Joint Dysfunction. Edited by Mehul J. Desai. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199350940.003.0019.

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Sacroiliac joint dysfunction is a common cause of chronic low back pain. Certain populations are particularly susceptible to disorders of this unique joint. Anatomically, the joint is complex, and the clinician must understand both intrinsic and extrinsic structures in its vicinity. Unfortunately, there are no particular pathognomonic findings on radiologic imaging. A cluster of physical examination findings has been recognized as demonstrating sacroiliac joint pain. Various treatment options exist in the evidence-based treatment of this condition.
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37

Shah, Chirag D., and Maunak V. Rana. Advances in Dorsal Column Stimulation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190626761.003.0017.

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Spinal cord stimulation (SCS) has been a long established therapy for various pain conditions including low back pain, failed back surgery syndrome, complex regional pain syndrome, and other neuropathic and nociceptive pain states. Since the first report of SCS in 1967 by Shealy, advances have occurred in the technology used to achieve clinical analgesia. Developments in both the hardware and software involved have led to significant improvements in functional specificity, as seen in dorsal root ganglion stimulation, along with increasing breadth and depth of the field of neuromodulation. The patient experience during the implantation of the systems, as well as post-procedurally has been enhanced with improvements in programming. These technological improvements have been validated in quality evidenced-based medicine: what was a static area now is a dynamic field, with neuromodulation poised to allow physicians and patients more viable options for better pain control for chronic painful conditions.
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38

Sullivan, Mark D. Health-Related Quality of Life as a Goal for Clinical Care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780195386585.003.0005.

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The importance of chronic illness has brought a new focus on patient-reported outcomes of clinical care. Health-Related Qualify of Life (HRQL) is a new goal for clinical care that combines a physician’s view of health as an objective biological fact and the patient’s view of health as a subjective experiential state. The diagnosis of an impersonal and objective disease separable from the patient arose after the French Revolution and helped to delimit the new right to health care. But objective mortality and morbidity metrics are not adequate for capturing the burden of chronic illness. HRQL was invented to capture the burden of chronic illness, but has not been successfully incorporated into clinical trials or clinical care. Chronic low back pain is presented as an example where both objective and subjective metrics of treatment success have failed. We need an openly patient-centered definition of health that is not just a supplement to objective disease diagnosis.
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39

Walsh, David A. Cervical and lumbar spine. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0157.

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Cervical and lumbar spine pain are major causes of disability and distress. Careful assessment is needed of the nature and extent of the problem, for diagnosis and exclusion of important (treatable) differential diagnoses, and for the formulation and engagement of the patient in an appropriate treatment plan. Acute spinal pain frequently does not indicate underlying joint pathology. Chronic spinal pain is often associated with intervertebral disc disease or which is often classified together with facet joint osteoarthritis as spondylosis. Sciatica, brachalgia, or spinal claudication may each be a consequence of either spondylosis or intervertebral disc prolapse. Simple mechanical low back and neck pain may respond well to conservative management with analgesics and physiotherapy. Specific spinal problems, such as neuronal compromise, may require additional treatments. The roles of injections and surgery in the management of spinal pain continue to evolve. Although ongoing management is largely determined by the individual's clinical response, comprehensive health economic analyses inform healthcare policies which may limit treatment availability. Many people with spinal problems suffer long-term or recurrent pain and disability, with significant psychological and social impact. Multidisciplinary approaches are needed to facilitate pain management and enable people with spinal pain to lead fulfilling lives when the underlying condition cannot be cured.
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40

Boonen, Annelies. Cost-of-illness and economic evaluations in axial spondyloarthritis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198734444.003.0025.

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Consideration of costs and budgets plays an increasingly important role in decisions on access to innovative technologies. When clinicians want to influence such decisions, it is essential to understand the information on the burden of the disease and the evidence on cost-effectiveness of technologies. This chapter provides guidance to understanding the key methodological principles of economic evaluations, and describes available evidence on these issues in axial spondyloarthritis (axSpA). In the prebiologics era, the cost-of-illness for society of ankylosing spondylitis was slightly lower than for rheumatoid arthritis, and substantially lower than chronic low back pain. Cost of sick leave and work disability accounted for up to 75% of total cost-of-illness. Treatment with biologics increased cost-of-illness substantially, but the important gain in quality-adjusted life years resulted in acceptable cost-effectiveness in patients with active disease. There remains a gap in knowledge about the cost-effectiveness of diagnosing and treating axSpA earlier.
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