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      Sustained acoustic medicine treatment of discogenic chronic low back pain: A randomized, multisite, double-blind, placebo-controlled trial

      research-article
      a , * , b , c , d
      Journal of Back and Musculoskeletal Rehabilitation
      IOS Press
      Low back pain, low-intensity continuous ultrasound, ultrasound therapy, sustained acoustic medicine, mechanotransduction, herniated discs, chronic pain, durable medical equipment

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          Abstract

          BACKGROUND:

          Sustained acoustic medicine (SAM) is a noninvasive long-term treatment that provides essential mechanical and thermal stimulus to accelerate soft tissue healing, alleviate pain, and improve physical activity. SAM increases localized deep tissue temperature, blood flow, cellular proliferation, migration, and nutrition exchange, resulting in reduced inflammation and an increased rate of tissue regeneration.

          OBJECTIVE:

          To assess the efficacy of SAM treatment of discogenic back pain in the lower spinal column to reduce pain, improve quality of life, and lower pharmacotherapy use.

          METHODS:

          Sixty-five subjects with chronic low back pain were randomly assigned to SAM ( N = 33) or placebo ( N = 32) groups. Subjects self-applied SAM device bilaterality on the lower lumbar region for 4 hours daily for 8 weeks and completed daily pain diaries before, during, and after treatment. Subjects recorded pain reduction using a numeric rating scale (NRS), medication use, and physical activity using the Global Rating of Change (GROC) and Oswestry Disability Index (ODI).

          RESULTS:

          SAM treatment significantly reduced chronic lower back pain from baseline relative to placebo treatment ( p < 0.0001). SAM treated subjects reported significantly lower back pain at 4 weeks, with the highest pain reduction ( - 2.58 points NRS, p < 0.0001) reported at 8 weeks. Similar trends were observed in improved physical activity (3.48 GROC, p < 0.0001, 69–88% ODI, p < 0.0001) and 22.5% (15.2 morphine milligram equivalent) reduction in the use of opioid medication from baseline to 8 weeks.

          CONCLUSION:

          Daily, home-use SAM treatment significantly improves the clinical symptoms of chronic lower back pain, improves physical mobility, and reduces daily medication use. SAM treatment is well-tolerated by patients and may be considered a safe, non-invasive treatment option for chronic discogenic, lower back pain.

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          Most cited references59

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          The rising prevalence of chronic low back pain.

          National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective of this study was to determine whether the prevalence of chronic LBP and the demographic, health-related, and health care-seeking characteristics of individuals with the condition have changed over the last 14 years. A cross-sectional, telephone survey of a representative sample of North Carolina households was conducted in 1992 and repeated in 2006. A total of 4437 households were contacted in 1992 and 5357 households in 2006 to identify noninstitutionalized adults 21 years or older with chronic (>3 months), impairing LBP or neck pain that limits daily activities. These individuals were interviewed in more detail about their health and health care seeking. The prevalence of chronic, impairing LBP rose significantly over the 14-year interval, from 3.9% (95% confidence interval [CI], 3.4%-4.4%) in 1992 to 10.2% (95% CI, 9.3%-11.0%) in 2006. Increases were seen for all adult age strata, in men and women, and in white and black races. Symptom severity and general health were similar for both years. The proportion of individuals who sought care from a health care provider in the past year increased from 73.1% (95% CI, 65.2%-79.8%) to 84.0% (95% CI, 80.8%-86.8%), while the mean number of visits to all health care providers were similar (19.5 [1992] vs 19.4 [2006]). The prevalence of chronic, impairing LBP has risen significantly in North Carolina, with continuing high levels of disability and health care use. A substantial portion of the rise in LBP care costs over the past 2 decades may be related to this rising prevalence.
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            • Article: not found

            Lumbar disc disorders and low-back pain: socioeconomic factors and consequences.

            Socioeconomic factors are important risk factors for lumbar pain and disability. The total costs of low-back pain in the United States exceed $100 billion per year. Two-thirds of these costs are indirect, due to lost wages and reduced productivity. Each year, the fewer than 5% of the patients who have an episode of low-back pain account for 75% of the total costs. Because indirect costs rely heavily on changes in work status, total costs are difficult to calculate for many women and students as well as elderly and disabled patients. These methodologic challenges notwithstanding, the toll of lumbar disc disorders is enormous, underscoring the critical importance of identifying strategies to prevent these disorders and their consequences.
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              • Record: found
              • Abstract: found
              • Article: not found

              Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials.

              To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments.
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                Author and article information

                Journal
                J Back Musculoskelet Rehabil
                J Back Musculoskelet Rehabil
                BMR
                Journal of Back and Musculoskeletal Rehabilitation
                IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )
                1053-8127
                1878-6324
                6 June 2024
                3 September 2024
                2024
                : 37
                : 5
                : 1321-1332
                Affiliations
                [a ]Department of Pain Management, Cayuga Medical Center , Ithaca, NY, USA
                [b ]Department of Osteopathic Medicine, Campbell University , Buies Creek, NC, USA
                [c ]Research Department, Orthopedic Foundation , Stamford, CT, USA
                [d ]Department of Orthopedics, Rutgers University , Barnabas Health, New Brunswick, NJ, USA
                Author notes
                [* ]Corresponding author: Ralph Ortiz, Department of Pain Management, Cayuga Medical Center, Ithaca, NY, USA. E-mail: ralphortiz.sam@ 123456gmail.com .
                Article
                BMR230402
                10.3233/BMR-230402
                11492000
                38905030
                85fc4296-65e7-47ba-bd5c-5b09501e21bd
                © 2024 – The authors. Published by IOS Press.

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 November 2023
                : 28 May 2024
                Categories
                Research Article

                low back pain,low-intensity continuous ultrasound,ultrasound therapy,sustained acoustic medicine,mechanotransduction,herniated discs,chronic pain,durable medical equipment

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