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Compose a 1750 words essay on Management of Myofascial Pain Syndrome. Needs to be plagiarism free!Download file to see previous pages... When diskectomy fails to improve a patients pain it is listed i
Compose a 1750 words essay on Management of Myofascial Pain Syndrome. Needs to be plagiarism free!Download file to see previous pages...
When diskectomy fails to improve a patients pain it is listed in the surgical literature as failed back surgery syndrome according to Fishbain and Cutler, (2007). There is some controversy in the literature as to what the definition actually should be. Fishbane et. al (2007) tells us that there is much disagreement as to the definition of FBSS and reviews all of those definitions in his study. Though there is disagreement most will agree that all of these patients have two similarities. These are that patients have chronic low back pain and they have one or more failed back surgeries (Fishbain et al. 2007), Slipman, Shin, Isaac, et. al (2002) however, presents us with a study that states that there are a myriad of reasons for the pain that these patients have. They used 42 exclusion criteria and finalized their study with the most common diagnosises being identified as spinal stenosis, internal disc disruption syndrome, recurrent/retained disc, and neural fibrosis. They felt that 95% of these patients could be told why they have pain.
Collella (2003) also reviews the various issues that often cause this pain. There is a belief that one of those is the formation of scar tissue in the area of the surgery causing pressure on the nerve root. Other theories include that the original disease may have reoccurred, there are complications, there is an altered posture, depression, anxiety, sleeplessness, or deconditioning. Collella (2007), believes that the most common cause is improper selection of the patient for surgery. It is felt that these patients are not good candidates because of poor trunk strength and deconditioning as well as obesity and lack of activity. Peter Ulrich (2008) agrees and discusses the fact that deconditioning is often the issue in his physicians review of the findings.
Duque, I., Parra JH, Duvallet, A. Et al (2009) completed a study on the effect of deconditioning on back pain with 70 patients. All 70 patients were of normal weight as to not confuse the study results. The conclusion was that physical fitness of patients who had chronic low back pain are comparable to that of a healthy but poorly conditioned adults. Gautsche, Hildebrandt &. Cadosch (2009) agree in their resultant study on acute back pain assessment and management. Gautsche et.al. (2009) states that 90% of all adults will experience at least one episode of back pain in their lifetime. The difference in the patient that will determine whether it will be chronic or not depends on the patients conditioning and core strength. According to this study deconditioning can lead to more severe problems such as cauda equine syndrome, cancer, infection and fracture. Haig AJ, Geissel ME, Michael, B et al. (2006) developed a multidisciplinary assessment protocol using a qualitative approach to decision making. This study performed in the University spine program determined that the final framework for assessment should include physical deconditioning, psychosocial issues, potential for cure, and dozens of subcategories.
Observational studies of patients with deconditioned core muscles were done by Smeets, Wade, &.Hedding et al.