• Title/Summary/Keyword: BACK PAIN

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The outcome of epiduroscopy treatment in patients with chronic low back pain and radicular pain, operated or non-operated for lumbar disc herniation: a retrospective study in 88 patients

  • Hazer, Derya Burcu;Acarbas, Arsal;Rosberg, Hans Eric
    • The Korean Journal of Pain
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    • v.31 no.2
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    • pp.109-115
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    • 2018
  • Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.

Does transcutaneous electrical nerve stimulation affect pain, neuropathic pain, and sympathetic skin responses in the treatment of chronic low back pain? A randomized, placebo-controlled study

  • Yaksi, Elif;Ketenci, Aysegul;Baslo, Mehmet Baris;Orhan, Elif Kocasoy
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.217-228
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    • 2021
  • Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients' visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

Comparison of the Pressure Pain Thresholds the Vertebral Segments Between Patients with Chronic Lower Back Pain and Healthy Individuals, and Correlation Between Pain, Dysfunction, and Psychological Status in Patients with Chronic Lower Back Pain (만성 요통 환자와 요통이 없는 건강한 대상자의 척추 뼈분절의 압통 역치 수준 비교와 만성 요통 환자에 통증 수준, 기능장애 및 심리사회적 수준 간에 상관성)

  • Jin-yeong Yoo;Suhn-yeop Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.29 no.3
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    • pp.73-84
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    • 2023
  • Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.

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Effect of Exercise on Low Back Pain in Pregnant Woman (임산부의 요통에 대한 운동요법의 효과)

  • Ahn, Myung-Hwan
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.104-111
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    • 2003
  • The purpose of this study was to identify the effect of exercise program of on improvement of low back pain in pregnant woman. The subject with pregnant woman were 24 members recruited among in pregnant woman of S Hospital in Bucheon between 25 and 35 years old. 24 patients were randomly distributed into two groups(Exercise group = 12, Control group = 12). William's back exercise, Pelvic floor muscle strengthening exercise and hydrotherapy were applied to Exercise group respectively. Control group were applied only hydrotherapy. The exercise program of low back was given four times a week for 12 weeks between september 2002 and March 2003. The results were compared by VAS(Visual Analog Scale) and MPQ(McGill Pain Questionnaire) at before exercise(12 weeks of pregnancy), after 6weeks(18 weeks of pregnancy) and after 12weeks(24 weeks of pregnancy). The results of this study were as follow : After the back exercise program in the Exercise group and control group improved low back pain by VAS and MPQ with no statistical significance. On the other hand, back pain by VAS and MPQ was statistical significantly improved in the Exercise group than control group.

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The Effect of Bridging Exercise on Dysmenorrhea Back Pain of Women University Students (교각운동이 월경곤란증으로 인한 허리통증을 가진 여대생에게 미치는 영향)

  • Jeong, Yeonwoo;Hong, Sanghyeon;Lee, Seunghyub
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.4
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    • pp.1-6
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    • 2016
  • Purpose : This study determines the effect and sustainability of the trunk stability exercise program, specifically using the bridge exercise, by measuring Visual Analogue Scale(VAS), Menstrual Distress Questionaire(MDQ) and muscle strength in women university students complaining of low back pain. Methods : The trunk stability exercise program was progressed by 22 women university students, for 4 weeks, (3 times a week, 1 hour per session). At this time, low back pain happened at the period of menstruation and was measured using VAS, Dysmenorrhea using the MDQ tool and abdominal and back muscle strength using HUR. This study was evaluated 4 times (before and after the exercise program, after 4 weeks and 8 weeks) to investigate the effect of time variation after the exercise program. Results : The trends showed a decrease in VAS and MDQ and an increase in abdominal and back muscle strength. Therefore, these results were evaluated positively from a statistical perspective(p<.05). Conclusions : The trunk stability exercise results in a decreased VAS and MDQ, and increases the muscle strength in women university students who complained of low back pain form dysmenorrhea. Therefore, the low back pain from dysmenorrhea could have been avoided and quality of everyday life improved.

The Comparison of Effectiveness between Near Acupuncture Point Needling and Near Acupuncture with Remote Acupuncture Point Needling on Treating Low Back Pain of Acute Stage (급성기(急性期) 요통(腰痛)의 침치료(鍼治療)에 있어서 근위취혈(近位取穴)과 원위취혈병용(遠位取穴倂用)의 비교(比較) 연구(硏究))

  • Park, Ki-Bum;Lee, Jin-Seok;Kim, Dae-Joong;Song, Kye-Hwa
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.61-68
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    • 2006
  • Objectives : The Purpose of this report is to examine the effect of Remote Acupuncture Point Needling in the Low Back Pain patient of Acute Stage. Methods : From October 1st 2005 to May 31th 2006, 30 cases of low back pain patients at acute stage were divided into 2 groups; one group(control group) took near acupuncture point needling, and the other group(test group) took near acupuncture point needling with remote acupuncture point needling. For evaluating change of pain, Visual Analog Scale(VAS) was checked before and after Treatment. Results : Both acupuncture therapy showed good effect on low back pain of acute stage. And test group showed better effect on decreasing pain than control group. It was proved by the difference between VAS checked before treatment and what checked after treatment. But it was not significant statistically. Conclusion : Near acupuncture point needling and remote acupuncture point needling can be recommended as a useful therapy to treat low back pain of acute stage.

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Application of Rasch Analysis to the Modified Oswestry Low Back Pain Disability Questionnaire for Work-Related Low Back Pain Patients (수정된 오스웨스트리 허리기능 장애 설문지의 라쉬분석: 산업장에서의 업무관련 요통환자를 대상으로)

  • Park, So-Yeon;Oh, Jae-Seop;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.15 no.3
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    • pp.26-34
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    • 2008
  • The purposes of this study were to assess and modify the original classification categories of the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) and to determine the unidimensionality of the modified ODQ applying Rasch Analysis. The data were obtained from 108 work-related low back pain patients by physical therapists. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4 response levels. Eight items from the modified ODQ fit the Rasch model. The items, "pain intensity" and "social life" showed misfit statistics. In general, the order of item difficulty of the remaining 8 items showed a logical item difficulty hierarchy with the "changing degree of pain" item being the most difficult and the "walk" item being the easiest. The results showed that further study is needed to expand the construct of ODQ including additional higher-level items related to work activities. This study may be useful for establishing a standard method to assess the functionality of low back pain patients.

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The Study of Factors Affecting Functional Disability of the Low Back Pain Patients Using Oswestry Disability Index(ODI) Assessment Tool (Oswestry Disability Index(ODI) 평가 도구를 이용한 요통환자의 기능장애에 영향을 미치는 요인 연구)

  • Lee, Sang-Ho;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.1
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    • pp.18-25
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    • 2007
  • Objective: The Purpose of this study is the factive and descriptive research to identify the factors affecting the functional disability of the chronic low back pain patients. We investigated the effect of ODI by the Questionnaire and questioned an 70 patients who were back pain unit at G university hospital in D city from March to May, 2007. The functional disorder in this study were based on the Oswestry Disability Index(ODI) lower back pain disability questionnaire by fairbank(1980), and these data were proceeded by using SPSS/WIN version 10.0. Result: 1. The functional disorder in accordance with age, gender, academic background, occupation, diagnosis, pain cause, pain experience, treatment duration had no significantly similar difference statistically(p>0.05). 2. The functional disorder in accordance with duration of painful generation had statistically significance(P<0.05). Conclusion: we could verify that duration of painful generation affect on the factors affecting the functional disability of the low back pain patients.

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Effects of a Multi-modal Exercise Program on Pain Intensity, Trunk Muscle Strength, and Oswestry Disability Index in Patients with Chronic Low Back Pain (다중운동 프로그램이 만성 요통 환자의 통증 강도, 몸통 근력 및 오스웨스트리 장애지수에 미치는 영향)

  • Park, Chan-ho;Kim, Jae-cheol;Yang, Yonng-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.26 no.2
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    • pp.19-27
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    • 2020
  • Background: The purpose of this study was to examine the effects of a multi-modal exercise program for patients with chronic low back with respect to pain intensity, trunk muscle strength and Oswestry disability index. Methods: Thirty patients with chronic low back pain were recruited and divided equally into two groups. The multi-modal training program comprised a series of exercises such as warm-up, stabilization exercises, stretching, endurance exercises, and cool down whereas the control group performed only stabilization exercises. The both group spent an equal amount of time performing 60 minutes per day, three times per week, for five weeks. Results: The experimental group demonstrated statistically significant improvements in range of motion, trunk muscle strength, the visual analogue scale, and the Oswestry Disability Index (p<.05). Intergroup comparison showed a statistically significant difference in the range of motion of the lumbar spine and the degree of disability in the experimental group. Muscle strength and pain were statistically significant in both groups. Conclusion: The multi-modal exercise program is effective for patients with chronic low back pain, as it reduces lower back pain, increases trunk muscles strength, and decrease the potential for becoming disabled.

Risk Factors of Work-related Low Back Pain in Manufacturing Workers (제조업 근로자들의 작업과 연관된 요통의 위험요인에 관한 연구)

  • Kim, D.H.;Shin, H.R.;Chun, J.H.;Kim, Y.W.;Kim, J.H.;Lee, C.U.
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.20-36
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    • 1993
  • Work-related low back pain is one of the major factors that cause the loss of working power especially in actively working age, therefore controlling the work-related low back pain is one of the major issues in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the efficient control program of the work-related low back pain. The subjects were male workers employed at the manufacturing industry in Pusan with longer than 6 months' working duration. The data was collected by self-reported questionnaire and interview from May 1 to October 31,1992. The contents of questionnaire were as follows:. the experience of low back pain within the recent one month, general characteristics(age, marital status, education level, religion, regular exercise), physical characteristics(height, weight), employment status(working duration, daily working hours, rest during work, satis(action fur the job), type of work and working environments(posture, forward bending, lifting and movement, satisfaction for table and chair). The result was analyzed for 608 entire respondents by case-control comparative method. The number of cases was 152 with a history of work-related low back pain, so the relative frequency of self-reported work-related low back pain was 25.0%, and the number of controls was 344 without any history of low back pain. As a result, two characteristics of the employment status(working duration, satisfaction fur the job) and all characteristics of type of work and working environments showed a statistical significance between the case and control groups(p<0.01). The Oddb ratios of these variables for Work-related low back pain were calculated. They were 7.88 for the satisfaction fur chair, 7.86 for lifting and movement,3.31 for satisfaction for table, and 2.22 fur bending forward(p<0.01). And for the multivariate logistic regression analysis confirmed that unsatisfaction for table was independent risk factor for Work-related low back pain. In summary, though this study was based upon the self-reported questionnaire and the subjective complaints, the satisfaction for chair, lifting and movement, satisfaction for table, and bending forward concerned with the type of work and working environments were considered as the main factors causing the work-related low back pain, and the work-related low back pain may be preventable by the ergonomic control of these factors.

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