Clinical Research Directory

Efficacy of Antibiotic Treatment for Patients With Chronic Low Back Pain and Modic Type I Changes - Randomized Placebo-controlled Trial

The goal of this clinical trial is to learn if antibiotics (amoxicillin) work to treat chronic low back pain in adults. In some patients, this type of back pain may be caused by bacteria in the vertebrae, resulting in a condition known as "Modic type I change." The main questions the trial aims to answer are: * What is the efficacy (primary objective) of antibiotic treatment for patients with chronic low back pain and Modic type I changes? * What is the cost-effectiveness (secondary objective) of antibiotic treatment for patients with chronic low back pain and Modic type I changes? Researchers will compare amoxicillin to a placebo (a look-alike substance that contains no active drug) to see if amoxicillin works to treat chronic low back pain. Participants in the trial will: * Be invited for an MRI scan to determine if they have a Modic type I change; those who do will be included in the study. * Take either amoxicillin or a placebo daily for 100 days. * Take probiotics daily for 100 days to reduce the occurrence and impact of any side effects from the antibiotics. * Attend clinic visits at baseline (the start), 4 weeks, 3 months, and 12 months for checkups and tests. * Complete questionnaires at baseline, 3 months, 6 months, and 12 months.

Feasibility and Acceptability of an Evidence-Informed Virtual Intervention to Reduce Perceptions of Injustice Following Work Injury

Many individuals who have sustained disabling injuries in the workplace react to their situation with a sense of 'injustice'. Research over the past 20 years has revealed that, interpreting one's post-injury life situation as 'unjust', actually interferes with recovery from the disabling injury. Post-injury perceptions of injustice contribute to more severe pain, more severe symptoms of depression and PTSD, and more prolonged absence from work. Several clinical researchers have highlighted the need to develop approaches to treatment that can reduce post-injury perceptions of injustice. A brief intervention was developed to reduce post-injury perceptions of injustice. The intervention consists of 4 30-minute sessions with a psychologist. The intervention is called 'Managing Post-Injury Challenges' (MPIC). The MPIC sessions are delivered virtually (online). As a first step toward determining whether MPIC has added value for promoting more successful recovery following work injury, the proposed research will assess the feasibility of MPIC. Some of the feasibility questions that will be addressed include: Are injured workers interested in participating in MPIC? Do injured individuals remain sufficiently engaged to complete all 4 sessions of MPIC? Does participation in MPIC contribute to meaningful reductions in perceived injustice? And are injured individuals satisfied with the benefits of MPIC? MPIC differs from many other rehabilitation interventions in that it focuses on a 'risk-factor' for problematic recovery as opposed to treating a specific health or mental health problem. At this time, there is little information about whether injured workers are interested in interventions focusing on 'risk factors' for problematic recovery. As a first step in evaluating the effectiveness of MPIC, it is necessary to demonstrate that MPIC is acceptable to injured workers. We would consider the study to be successful if 1) at least 75% of eligible injured workers agree to enrol in MPIC, 2) if at least 75% of participants attend all 4 sessions of MPIC, and if at least 75% of participants are satisfied with the benefits they derived from their involvement in MPIC. If MPIC is ultimately shown to be effective in reducing post-injury perceptions of injustice, offering MPIC to injured workers with elevated scores on a measure of perceived injustice could contribute to more successful recovery.