Advertisement for orthosearch.org.uk
Results 1 - 9 of 9
Results per page:
Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 20 - 20
1 Sep 2019
Harrisson S Ogollah R Dunn K Foster N Konstantinou K
Full Access

Background

Medication prescribing patterns for patients with neuropathic low back-related leg pain (LBLP) in primary care are unknown.

Purpose

To estimate the proportion of patients prescribed pain medications, describe baseline characteristics of patients prescribed neuropathic pain (NP) medication and estimate the proportion of LBLP patients with refractory NP.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 30 - 30
1 Sep 2019
Harrisson S Ogollah R Dunn K Foster N Konstantinou K
Full Access

Background

There is a paucity of prognosis research in patients with neuropathic low back-related leg pain (LBLP) in primary care.

Purpose

To investigate the clinical course and prognostic factors in primary care LBLP patients consulting with neuropathic pain (NP).


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 28 - 28
1 Feb 2018
Harrisson S Ogollah R Dunn K Foster N Konstantinou K
Full Access

Background

Patients with low back-related leg pain (LBLP) can present with neuropathic pain; it is not known but is often assumed that neuropathic pain persists over time. This research aimed to identify cases with neuropathic pain that persisted at short, intermediate and longer-term time points, in LBLP patients consulting in primary care.

Methods

LBLP patients in a primary care cohort study (n=606) completed the self-report version of Leeds Assessment for Neurological Symptoms and Signs (s-LANSS, score of ≥12 indicates possible neuropathic pain) at baseline, 4-months, 12-months and 3-years. S-LANSS scores and percentages of patients with score of ≥12 are described at each time-point. Multiple imputation was used to account for missing data.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 24 - 24
1 Feb 2018
Ely S Stynes S Ogollah R Foster N Konstantinou K
Full Access

Background

Criticisms about overuse of MRI in low back pain are well documented. Yet, with the exception of suspicion of serious pathology, little is known about factors that influence clinicians' preference for MRI. We investigated the factors associated with physiotherapists' preference for MRI for patients consulting with benign low back and leg pain (LBLP) including sciatica.

Methods

Data were collected from 607 primary care patients consulting with LBLP and assessed by 7 physiotherapists, in the ATLAS cohort study. Following clinical assessment, physiotherapists documented whether he/she wanted the patient to have an MRI. Factors potentially associated with clinicians' preference for imaging were selected a priori, from patient characteristics and clinical assessment findings. A mixed-effect logistic regression model examined the associations between these factors and physiotherapists' preference for MRI.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_10 | Pages 17 - 17
1 May 2017
Stynes S Konstantinou K Ogollah R Hay E Dunn K
Full Access

Background

Low back-related leg pain (LBLP) is clinically diagnosed as referred leg pain or sciatica. Within the spectrum of LBLP there may be unrecognised subgroups of patients. This study aimed to identify and describe clusters of LBLP patients using latent class analysis (LCA).

Methods

The study population were 609 LBLP primary care consulters. Variables from clinical assessment were included in the LCA. Characteristics of the statistically identified clusters were described and compared to the clinically defined groups of LBLP patients.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_10 | Pages 16 - 16
1 May 2017
Harrisson S Ogollah R Dunn K Foster N Konstantinou K
Full Access

Purpose of study and background

Neuropathic pain is a challenging pain syndrome to manage. Low back-related leg pain (LBLP) is clinically diagnosed as either sciatica or referred leg pain and sciatica is often assumed to be neuropathic. Our aim was to describe the prevalence and characteristics of neuropathic pain in LBLP patients.

Methods

Analysis of cross-sectional data from a prospective, primary care cohort of 609 LBLP patients. Patients completed questionnaires, and received clinical assessment including MRI. Neuropathic characteristics (NC) were measured using the self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs scale (SLANSS; score of ≥12 indicates pain with NC).


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_8 | Pages 74 - 74
1 Apr 2017
Raval P Ogollah R Hall A Foster N Roddy E
Full Access

Introduction

Subacromial corticosteroid injection is widely used in the treatment of Subacromial Impingement Syndrome (SIS). There is increasing interest in using ultrasound (US) to improve the accurate placement of injections. This study investigated whether the accuracy of placement of US-guided subacromial corticosteroid injections influences patients' outcome of pain and function.

Method

Secondary analysis of data from a 2−2 factorial randomised controlled trial investigating exercise and corticosteroid injection for pain and function in SIS. US-guided injections were delivered according to a pre-defined protocol. Video images were reviewed to categorise accuracy of injection into the subacromial bursa into 3 accuracy groups using pre-defined criteria: 1) not in the subacromial bursa; 2) probably in the subacromial bursa; and 3) definitely in the subacromial bursa. The primary outcome measure was the self-reported Shoulder Pain and Disability Index (SPADI) total score, compared at 6 weeks and 6 months. Secondary outcomes included SPADI pain and function subscales and participant global rating of overall change from baseline. A mixed effects model was used to compare accuracy groups' outcomes at 6 weeks and 6 months, adjusted for baseline covariates.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_6 | Pages 26 - 26
1 Feb 2016
Stynes S Konstantinou K Ogollah R Hay E Dunn K
Full Access

Background:

Identification of nerve root involvement (NRI) in patients with low back-related leg pain (LBLP) can be challenging. Diagnostic models have mainly been developed in secondary care with conflicting reference standards and predictor selection. This study aims to ascertain which cluster of items from clinical assessment best identify NRI in primary care consulters with LBLP

Methods:

Cross-sectional data on 395 LBLP consulters were analysed. Potential NRI indicators were seven clinical assessment items. Two definitions of NRI formed the reference standards: (i) high confidence (≥80%) NRI clinical diagnosis (ii) high confidence (≥80%) NRI clinical diagnosis with confirmatory magnetic resonance imaging (MRI) findings. Multivariable logistic regression models were constructed and compared for both reference standards. Model performances were summarised using the Hosmer-Lemeshow statistic and area under the curve (AUC). Bootstrapping assessed internal validity.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 6 - 6
1 Feb 2015
Konstantinou K Dunn K Ogollah R Hay E
Full Access

Background

60% of back pain patients report pain radiation in the leg(s), which is associated with worse symptoms and poorer recovery. The majority are treated in primary care, but detailed information about them is scarce. The objective of this study is to describe the characteristics of patients with back and leg pain-seeking treatment in primary care.

Methods

Adult patients consulting their GP with back and leg pain were invited to the study. Participants completed questionnaires including sociodemographic, physical and psychosocial measures. They also underwent standardised clinical assessments by physiotherapists, and received an MRI scan.