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      Non-Spinal Causes of Back Pain: An ‘undiagnosed’ diagnosis

      Journal of Medical Research and Innovation
      JMRI Publications

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          Abstract

          Low back pain is a common ailment affecting individuals all around the globe. Majority of Disability Adjusted Life Years lost amongst working population is due to low back pain. Though majority of surgeons/physicians keep only spinal causes in mind while treating such an ailments, a number of other causes exist for such a pathology. This editorial aims to make the readers aware about such non spinal causes of low back pain.

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          Most cited references3

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          The association between obesity and low back pain: a meta-analysis.

          This meta-analysis assessed the association between overweight/obesity and low back pain. The authors systematically searched the Medline (National Library of Medicine, Bethesda, Maryland) and Embase (Elsevier, Amsterdam, the Netherlands) databases until May 2009. Ninety-five studies were reviewed and 33 included in the meta-analyses. In cross-sectional studies, obesity was associated with increased prevalence of low back pain in the past 12 months (pooled odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14, 1.54), seeking care for low back pain (OR = 1.56, 95% CI: 1.46, 1.67), and chronic low back pain (OR = 1.43, 95% CI: 1.28, 1.60). Compared with non-overweight people, overweight people had a higher prevalence of low back pain but a lower prevalence of low back pain compared with obese people. In cohort studies, only obesity was associated with increased incidence of low back pain for > or =1 day in the past 12 months (OR = 1.53, 95% CI: 1.22, 1.92). Results remained consistent after adjusting for publication bias and limiting the analyses to studies that controlled for potential confounders. Findings indicate that overweight and obesity increase the risk of low back pain. Overweight and obesity have the strongest association with seeking care for low back pain and chronic low back pain.
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            Relationships among pain, anxiety, and depression in primary care.

            Pain, anxiety, and depression are commonly seen in primary care patients and there is considerable evidence that these experiences are related. This study examined associations between symptoms of pain and symptoms and diagnoses of anxiety and depression in primary care patients. Results indicate that primary care patients who endorse symptoms of muscle pain, headache, or stomach pain are approximately 2.5-10 times more likely to screen positively for panic disorder, generalized anxiety disorder, or major depressive disorder. Endorsement of pain symptoms was also significantly associated with confirmed diagnoses of several of the anxiety disorders and/or major depression, with odds ratios ranging from approximately 3 to 9 for the diagnoses. Patients with an anxiety or depressive disorder also reported greater interference from pain. Similarly, patients endorsing pain symptoms reported lower mental health functioning and higher scores on severity measures of depression, social anxiety, and posttraumatic stress disorder. Mediation analyses indicated that depression mediated some, but not all of the relationships between anxiety and pain. Overall, these results reveal an association between reports of pain symptoms and not only depression, but also anxiety. An awareness of these relationships may be particularly important in primary care settings where a patient who presents with reports of pain may have an undiagnosed anxiety or depressive disorder.
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              A study of patient satisfaction level in inpatient spine department of a tertiary care multi-speciality hospital

              Background: Patient satisfaction at spine surgery centers is a matter of concern. In specialized surgeries like spine, the satisfaction of a patient is not merely because of surgical outcomes but also empathy of doctor, rehabilitation programs and friendliness of the hospital. Aims and Objectives: This study aims to investigate the prognosis and satisfaction level of patients/relatives operated with spinal surgery. This shall not only help the spinal hospitals to know the ways to improve the patient outcome but methods to provide better services. Material and methods: The study was conducted by carrying out survey amongst 39 patients and their relatives at inpatient department of spine surgical unit by using structured questionnaire and analysing the data using SPSS software. The patients were examined before and after surgery and their VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) were also documented. The SERVQUAL methodology was also studied to understand if it could be implemented in the study to understand better and make the study more conclusive.   Results: The study composed of 39 individuals with an average age of 75.6 +-10.2 years.39 percent of the study group were females and 61 percent males. The ODI score in post-operative stage (18.97+_12.97) was significantly reduced as compared to pre-operative stage (76.66+-17.23) (p<0.05). The VAS score in post-operative stage (1.48 +-1.8) was also significantly reduced as compared to pre-operative stage ( 9.51 +- 0.22) (p<0.05). Ninety-Two percent people were satisfied with the housekeeping services while Ninety-Eight percentage were satisfied with the medical care provided. Ninety-five percentage of people were satisfied by the behaviour of staff and nurses. The nursing department, cleanliness and behaviour of the doctor satisfied 90 percent, 87 and 84.59 percent. The admission and reception satisfied only 66 percentage . The SERVQUAL study was not incorporated because the questionnaire designed through this methodology requires to be administrated by face to face interviews along with moderate to large sample size for statistical reliability.   Conclusion: This study has clearly shown that satisfactory results are obtained after spine surgery. However, the  results are better when performed by a fellowship trained surgeon. Moreover, doctors who spend time in explaining the ailments and possible outcomes to the patients have more satisfactory results. A caring attitude of the staff and empathy in interaction makes a lot of difference in the success of the practice of a surgeon.
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                Author and article information

                Journal
                Journal of Medical Research and Innovation
                J Med Res Innov
                JMRI Publications
                2456-8139
                July 01 2019
                February 17 2019
                : e000172
                Article
                10.32892/jmri.172
                e676ba6a-170a-481d-ab74-d9829a6eeac9
                © 2019

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