Ospecifik ländryggssmärta är den vanligaste typen av ländryggssmärta och saknar identifierbar patoanatomisk orsak, därför har det blivit en utmaning att utveckla effektiva behandlingar. Det saknas nationella riktlinjer i Sverige för fysioterapeutisk behandling av ospecifik ländryggssmärta. Det är oklart vilka typer av åtgärder som idag används av svenska fysioterapeuter.  Syftet med studien var att kartlägga vilka fysioterapeutiska åtgärder för ospecifik ländryggssmärta som används av fysioterapeuter i Sverige samt undersöka om det föreligger eventuella skillnader i val av åtgärd mellan offentligt och privat anställda fysioterapeuter och mellan kvinnliga och manliga fysioterapeuter.  Studien var en kvantitativ tvärsnittsstudie av deskriptiv och komparativ design. Urvalet var ett bekvämlighetsurval bestående av yrkesverksamma fysioterapeuter i Sverige. Data samlades in via en enkät som besvarades av 105 fysioterapeuter.  De mest frekvent använda åtgärderna var information och råd kring fysisk aktivitet, sedan följde information om ergonomi, information om smärtmekanismer, muskelstärkande träning samt träning av rörlighet. Privat anställda fysioterapeuter använde laserterapi (p=0.020), massage (p=0.006), samt yoga (p=0.013) oftare i genomsnitt jämfört med offentligt anställda. McKenzie träningsprogram (p=0.010) var mer frekvent använt av offentligt anställda i genomsnitt. Kvinnliga fysioterapeuter använde aerob träning (p=0.012), akupunktur (p=<0.001), information om ergonomi (p=0.023), träning av balans (p=0.013), träning av bålstabilitet med motorisk kontroll (p=0.012), träning av rörlighet (p=0.016) samt TENS (p=<0.001) oftare än manliga.      Studien visade att det i övrigt fanns mycket likhet mellan grupper men att typen av anställning samt kön kan påverka till en viss utsträckning val av åtgärder. / Nonspecific low back pain is the most common type of low back pain and lacks an identifiable pathoanatomical cause, which makes it difficult to develop effective treatments. There are no national guidelines in Sweden for this condition and it is unclear what methods are currently used by Swedish physiotherapists. The purpose of the study was to map physiotherapeutic measures for nonspecific low back pain used by physiotherapists in Sweden and to investigate whether there are differences between public and private physiotherapists and between female and male physiotherapists. The study was a quantitative cross-sectional study of descriptive and comparative design. The sample was a convenience sample and the data were collected via a questionnaire that was answered by 105 physiotherapists.  The most frequently used methods were information and advice on physical activity, followed by information about ergonomy, information on pain mechanisms, muscle-strengthening training and training of mobility. Laser therapy (p=0.020), massage (p=0.006) and yoga (p=0.013) were more often used by public physiotherapists while McKenzie training programme (p=0.010) was more often used by public physiotherapists. Female physiotherapists used aerobic training (p=0.012), acupuncture (p=<0.001), information about ergonomy (p=0.023), training of balance (p=0.013), training of core stability with motorical control (p=0.012), träning of mobility (p=0.016) and TENS (p=<0.001) more often than male physiotherapists.  The study showed that there were strong similarities between groups but that the type of employment and gender can affect to a certain degree the choice of measures.

Abstrakt Bakgrund: Ryggsmärta ett subjektivt och multidimensionellt problem som påverkar många personers vardag. Kronisk ryggsmärta är ofta ett livslångt tillstånd med stor personlig betydelse som personen måste lära sig leva med. Ryggsmärtan måste därmed förstås respekteras av sjuksköterskan. Syfte: Syftet med litteraturstudien var att beskriva vuxna personers erfarenheter av att leva med kronisk ryggsmärta.  Metod: En litteraturstudie baserad på åtta kvalitativa intervjustudier. Datainsamling av inkluderade artiklar utfördes i databaserna CINAHL och PubMed. Analys gjordes enligt Fribergs femstegsmall. Resultat: Analysen resulterade i fyra kategorier: ”Ryggsmärtan påverkar fysiskt”, ”Känslorna och självuppfattningen påverkas”, ” Sociala livet förändras” och ” Hitta balans i tillvaron”. Konklusion: Kronisk ryggsmärta påverkade flera aspekter av personers liv och gav liknande men unika erfarenheter. Personer med ryggsmärta påverkades inte bara av ryggsmärtan utan av andra personers förhållningssätt och omgivande faktorer. Sjuksköterskan kan använda erfarenheterna och kunskap om personernas beteenden för att främja anpassning och hälsa samt möjliggöra bättre bemötande, förståelse och personcentrerad omvårdnad. / Abstract Background: Back pain is a subjective and multidimensional problem that affect many people’s everyday lives. Chronic back pain is often a lifelong condition with great personal significance that the person must learn to live with. Therefore, back pain must be understood and respected by the nurse. Aim: The aim of the literature study was to describe adults’ experiences of living with chronic back pain. Methods: A literature study based on eight qualitative interview studies. Data collection of included articles was performed in the CINAHL and PubMed databases. Analysis was done according to Friberg’s five-step model. Results: The analysis resulted in four categories: “Back pain affects physically”, “Emotions and self-perception are affected”, “The social life changes” and “Finding balance in in life”. Conclusion: Chronic back pain affected several aspects of people’s lives and gave similar but unique experiences. People with back pain were not only affected by their back pain but also other people’s attitudes and surrounding factors. Nurses can use the experiences and knowledge of the people’s behaviour to promote adaption and health as well as enable better approach, understanding and person-centred care.

This article focuses on the distribution of backpack pressure on human body. We have noticed two interesting situations: whether the length of different backpack shoulder straps will change the pressure distribution of the backpack on the human body and whether different positions of the backpack load will change the pressure distribution of the backpack on the human body. To find the answer, we designed a backpack pressure detection system to collect data and use engineering software to analyse the data.We got the range that best fits the human body and the healthiest backpack: when the distance from the top of the backpack to the shoulder is about 1/5 of the length of the shoulder and the weight of the backpack is at the bottom of the backpack. At this time, the force of the three parts of the human body (shoulders, back) is the most uniform and relatively minimal. If the user wants to minimize the pressure on the shoulder, the shoulder strap of the backpack should be as short as possible. If the user only wants the pressure on the back to be minimal, the weight in the backpack is closer to the back, which is better for the back.

Bakgrund: Smärta är en individuell psykologisk och emotionell reaktion där funktionen är att varna för skada. Långvarig smärta är en smärta som varar i mer än 12 veckor som drabbar 40–50 procent av Sveriges befolkning.  Den vanligaste lokalisationen för smärtan är ländryggen och det är ett av de största folkhälsoproblemen i världen. Orsaken till ländryggssmärta kan vara både fysiologisk och psykologisk, men det är oklart till varför det uppstår en långvarig smärta. Syfte: Syftet var att beskriva patienters upplevelse av att leva med långvarig ländryggssmärta. Metod: En litteraturöversikt gjordes som är baserad på tio kvalitativa vetenskapliga artiklar. Tre databaser användes, CINAHL Complete, Pubmed och Medline och dataanalysen gjordes enligt Fribergs analysmodell. Resultat: Tre huvudteman med tillhörande subtema påfanns under dataanalysen. Första huvudtemat var: Påverkan på vardagen med subteman: Förändringar i vardagen, Familjeroll, Kultur och religion och Acceptans. Andra temat var: Psykisk ohälsa och försämrad sömnkvalitet med subteman: Psykisk påverkan och Sömnsvårighet samt sista temat: Egenvård. Diskussion: Diskussionen är indelad i en metoddiskussion och resultatdiskussion. Metoddiskussionen innehåller en reflektion kring den valda metodens styrkor och svagheter. Resultatdiskussionen innehåller en diskussion om litteraturöversiktens resultat med Katie Erikssons teori som teoretisk utgångspunkt. / Background: Pain is an individual psychological and emotional reaction where the function is to warn of injury. Chronic pain is a pain that lasts for more than 12 weeks, that affects 40–50 percent of the population of Sweden. The most common location for the pain is the lumbar spine and is one of the biggest public health problems in the world. The cause of low back pain is both physiological and psychological, but it is unclear why chronic pain occurs. Aim: The purpose was to describe the patient’s experience of living with chronic low back pain. Method: A litterature review was made based on ten qualitative scientific articles. Three databeases were used, CINAHL Complete, Pubmed and Medline. The data analysis was done according to Friberg´s analysismodel. Results: Three main themes and associated subthemes were found during the data analysis of the result, containing subthemes. The first maintheme was: Impact on everyday life with subthemes: Changes in everyday life, Family role, Culture and religion and Acceptance. The second theme was: Mental illness and insomnia with subthemes: Psychological impact and Sleep deprivation, and the last theme was: Self-care. Discussion: The discussion is divided into a method-discussion and result discussion. The method discussion contains a reflection on the strengths and weaknesses of the chosen method. The result discussion includes a discussion of the results of the literature review with Katie Eriksson´s theory as a theoretical starting point.

Bakgrund Forskning visar att en stor del av Sveriges äldre befolkning lider av långvarig ryggsmärta. Trots frekventa besök till hälso- och sjukvården känner de sig otillfredsställda med bemötandet och smärtbehandlingen. Ryggsmärta är en individuell upplevelse beroende på lokalisation och intensitet med olika psykologiska och emotionella dimensioner. Flertalet faktorer samverkar och påverkar smärtupplevelsen. Syfte Att belysa äldres upplevelser av att leva med långvarig ryggsmärta. Metod En systematisk litteraturöversikt där befintliga data från tio kvalitativavetenskapliga originalartiklar samlades in, analyserades och sammanställdes genom dataextraktion, till resultatet. Resultat Två huvudkategorier urskildes: Lidandets dimensioner och Lindrandets aspekter. Att leva med långvarig ryggsmärta var ett mångdimensionellt lidande. Smärtan var ständigt närvarande och oförutsägbar. Sömnbrist gjorde att smärtanintensifierades. Positivt tänkande samt fysisk och social aktivitet var faktorer för lindring. Att bli sedd och lyssnad på ökade delaktigheten och minskade lidandet. Slutsats Att leva med långvarig ryggsmärta påverkar de äldre på olika sätt, dygnet runt, i alla sammanhang. Upplevelsen av delaktighet i kontakt med vården, att bli sedd som unik person med egna erfarenheter, minskar lidandet, höjer välbefinnandet och livskvaliteten. Studien förbättrar förståelsen för hur äldre personer upplever de psykologiska, fysiska, emotionella och sociala effekterna av att leva med långvarig ryggsmärta. / Background Research shows that a large part of Sweden´s elderly population suffers from chronic back pain. Despite frequent visits to the health service, they feel dissatisfied with the treatment. Chronic back pain is an individual experience depending on location and intensity with different psychological and emotional dimensions. Several factors interact and affect the experience of pain. Aim To shed light on the elderly´s experiences of living with chronic back pain. Method A systematic literature review where existing data from ten qualitative scientific original articles were collected, analyzed and compiled through data extraction, to the result. Result Two main categories were distinguished: the dimensions of suffering and the aspects of relief. Living with chronic back pain was a multidimensional suffering. The pain was constantly present and unpredictable. Lack of sleep intensified the pain. Positive thinking as well as physical and social activity were factors for relief. Beeing seen and listened to, increased participation and reduced suffering. Conclusion Living with chronic back pain affects the elderly in different ways, around the clock, in all contexts. The experience of participation in contact with health care, to be seen as a unique person with own experiences, reduces suffering, increases well-being and quality of life. The study improves the understanding of how the elderly experience the psychological, physical, emotional and social effects of living with chronic back pain.

No description available.

Back pain is a chronic disease epidemic and the most common chronic painful condition in Americans. It is associated with human suffering and enormous financial and social burdens. Smoking is a prevalent and harmful health behavior and is the greatest modifiable risk factor for many chronic diseases. Cigarette smoking is associated with back pain, but there is little research on this relationship among adults in the United States. Using biopsychosocial theory, this study examined (a) the prevalence of back pain (dependent variable) among smokers, former smokers, and never smokers (independent variable), and (b) the influence of age, sex, race, body mass index, level of physical activity, level of education, depression, and anxiety on predicting the likelihood of back pain. This cross-sectional secondary analysis of the 2012 National Health Interview Survey included over 34,000 respondents and utilized chi-square distribution, t test, one-way analysis of variance, and multiple logistic regression analysis. People who self-reported being anxious or worried, had been diagnosed with depression by a health care provider, were current or former smokers, obese, or failed to meet recommended levels of physical activity were more likely to have back pain. This study has implications for social change in the United States because it shows that anxiousness, depression, smoking, obesity, and low physical activity are risk factors for back pain in Americans. Further, it indexes the need for primary studies of the relationship between smoking and back pain to determine whether smoking is causal for back pain. These studies could lead to public health interventions that develop strategies to prevent back pain and thereby alleviate some of the social burden associated with this common and costly ailment.

Chronic low-back pain is a prevalent and costly problem for many adults in the United States. Currently, multidisciplinary treatment approaches are the treatment of choice for this problem. A meta-analysis was conducted on 43 published studies to describe the nature of these programs, the patients involved in them, treatment efficacy at discharge and follow-up, and possible relationships between these characteristics and outcome. Results show that these programs were often in university medical settings, with an emphasis on active patient participation. Common treatment approaches included physical therapy, skills training, medication management, supportive therapy, and behavior modification. Patients involved in these programs tended to be middle-aged, married, unemployed, and high-school educated, with an average pain duration of about five years. It was concluded that patients do show improvement at treatment completion (at least one-half standard deviation change) in physical fitness, reported distress levels, daily activity, and medication usage. At follow-up improvement over pre-treatment levels was still evidenced in reported distress levels, medication usage, mood, fitness levels, daily activities, and health perceptions. Results of correlational analyses suggest that the more impaired patients in these studies tended to show greater improvement. Data also suggest that patient dropouts rates were negatively correlated to medication usage and mood over time. Thus, improvements in these areas may be artifacts due to patient drop-out rates. Multidisciplinary treatment programs were found to be generally effective in promoting more adaptive functioning in their patients . However, it is recommended that closer attention be given to attrition rates and other potential sources of bias to maximize confidence in treatment effectiveness.

Given the prevalence and cost of low back pain, particularly among workers' compensation patients, it is advantageous to understand how various psychological constructs may be related to prolonged disability and failure to return to work. Malingering is a psychological construct that is clearly relevant for worker compensation populations and is a construct that is well suited for experimental control within an analog study. Malingering is the intentional exaggeration of physical or psychological symptoms that are motivated by external incentives such as time away from work. The ability to detect malingering in such a population with psychological assessments is unclear. An analog study was conducted in which we instructed college students to portray themselves as injured workers who received a back injury that required them to be off work while they recovered. Students were then told that they would be seeing a psychologist who would attempt to ascertain their abilities to return to work via the MMPI-2. Students were then randomly instructed to respond to the MMPI-2 in three different ways: a control condition was instructed to respond as if they suffered a workplace back injury that resulted in significant pain; a subtle fake-bad condition who received the control instruction plus were informed they did not enjoy their work and their back injury allowed them to enjoy personal and family time more; and a fake-bad condition that received the control instruction plus were asked to deliberately portray themselves as experiencing physical symptoms severe enough to keep them off work longer. Currently, no assessment of malingering exists within a compensated low back pain population. The purpose of this study was to determine if the MMPI-2 can be used to differentially identify "patients" who are instructed to report symptoms veridically versus "patients" instructed to consciously feign and magnify symptoms in an effort to avoid returning to work. Malingering and non-malingering patients' scores on the MMPI-2 validity and clinical scales were subjected to a cluster analysis to determine if a malingering profile could be accurately identified. A 5-cluster validity solution and 4-cluster clinical (both with K correction) solution were accepted. Substantially lower scores on L and K, elevated scores on F on the 5-cluster validity solutions, distinguished the "malingering" profile. The 4-cluster clinical solution was characterized by elevated scores on the clinical scales of hypochondriasis, depression, paranoia, and schizophrenia, which distinguished the "malingering" profile. The results indicate that the MMPI-2 could be useful in detecting malingering in compensated back pain patients. Results are discussed in the context of pain studies.

No description available.