• Title/Summary/Keyword: BACK PAIN

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Approach of Conservative Treatment in Low Back Pain (요통의 보존적 치료 접근)

  • Kang, Jeom - Deok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.79-84
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    • 2007
  • Purpose: The data was performed to evaluate the effect of conservative treatment in 30 patients aging from 21 to 71 with lumbar back pain. Methods: The effect of conservative treatment was analyzed with use of pain behavior scale, pain self assessment scale by Million Index in according to age, occupation, duration of symptom, symptom. Results: The occupation were desking job 43.4%, standing job 33.3%, house wife 23.3%. Duration of symptoms in over 2-5 months was 40.0%. The pain in below 1 months, classified by duration of symptoms, was reduced from 2.1 to 3.0 in pain behavior scale, 6.0 to 2.2 in pain self assessment scale(p<0.05). The pain in only lumbar back pain, classified by symptoms, was reduced from 2.0 to 3.0 in pain behavior scale, 6.6 to 2.4 in pain self assessment scale(p<0.05). Conclusion: The pain in over 9 months. classified by duration of physical therapy, was increase 2.0 in pain behavior scale, 4.0 in pain self assessment scale (p<0.05).

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The Determinants of the Quality of Life and Pain of Back Pain Patients (척추질환 환자의 삶의 질과 통증에 영향을 미치는 요인)

  • Lee, Jin-Gyu;Jin, Ki-Mam
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.505-512
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    • 2010
  • Objectives: Because of the changing life style of Koreans, we have witnessed an increase of patients with back pain. The development of medical knowledge and technology has resulted in more numerous and better treatment methods. However, the outcomes of diverse treatments have been examined by using a few medicine-oriented measures like pain. This study aims at identifying the factors that influence the outcomes of back pain treatments by using two outcome measures (e.g., quality of life and pain). Methods: We used the questionnaire survey method for data collection. The questionnaires contained 5 categories (treatment methods, clinical conditions, exercise, quality of life and, socio-demographic characteristics). We interviewed 188 back pain patients. We used the regression analysis method to predict the quality of life or pain. Results: Surgery showed a statistically significant effect on the quality of life as well as pain. The illness period, age and exercise were turned out to be significant factors for both of the dependent variables. The social class and surgery methods showed a statistically significant effect solely on the quality of life. Conclusions: In choosing the surgical methods, doctors need to provide detailed explanations on the quality of life outcomes for each of the surgical methods to the patients.

Back Pain of Muscular Origin (근긴장성 요통의 치료에 대한 새로운 소견)

  • Choi, Joong-Rieb
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.83-95
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    • 1993
  • In out-patient clinic, it seems to be common that most back pain arise from muscular origins rather than from skeletal origins. Most physicians have wished to diagnose lower back pain from the radiologic findings only. From clinical experiences and anatomical studies, I have gotten a different opinion from common sense about backaches. If I met a patient who had lower back pain around the posterior superior iliac crest(P.S.I.C.) area, I would had to search a trigger point in the erector spinae muscles at the level of thoraco-lumber junction rather than at the level of the painful site. It is why that sensory innervation over the posterior superior iliac crest area is the posterior primary branch of T12 spinal nerve running down through the erector spinae muscles. Pain on the iliac crest area is supposedly due to hyperirritability of the sensory nerve distributing to this area. Hyperirritability of the posterior primary branch of $T_{12}$ spinal nerve may be due to the spasm of the longissimus thoracis muscle in the erector spinae muscles at the level of the thoraco-lumbar junction. So finally, I would like to insist that spasmolytic treatment on the muscle at the level of the thoraco-lumbar junction would be better for pain relief around P.S.I.C. than treatment at the painful site only.

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Effect of Proprioceptive Neuromuscular Facilitation Stretching on Pain, Hip Joint Range of Motion, and Functional Disability in Patients with Chronic Low Back Pain

  • Kim, Beomryong;Kang, Taewoo;Kim, Dahee
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.225-234
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    • 2021
  • Objective: We aimed to identify the effects of proprioceptive neuromuscular facilitation (PNF) stretching on pain, hip range of motion, and functional disability in patients with chronic low back pain. Design: Randomized controlled trial Methods: In total, 45 patients with chronic low back pain were randomly divided into a conventional stretching group (n=22) and a PNF stretching group (n=23). Both interventions were performed three times per week for 6 weeks. Assessments were made using the visual analog scale, Flexion-Abduction-External Rotation test, modified Thomas test, prone hip extension test, and Oswestry disability index before and after the 6-week intervention period. We conducted a paired t-test to compare the within-group findings before and after the intervention. An independent t-test was used to compare the between-group differences. The statistical significance level was set at α=0.05, for all variables. Results: Both groups showed significant improvements in pain, hip range of motion, and functional disability after the intervention (p<0.05). A significant difference was observed in pain, hip range of motion, and functional disability in patients belonging to the PNF stretching group (p<0.05). Conclusions: This study provides evidence that the application of PNF stretching can effectively reduce pain and improve hip range of motion and functional disability in patients with chronic low back pain.

Non-operative Korean Medicine Treatment for Four Patients with Failed Back Surgery Syndrome after Spinal Fusion Surgery : A Retrospective Case Series

  • Seo, Young Hoon;Lee, Jeong Ryo;Lee, Sang Min;Kim, Min Chul;Kim, Yu Jong;Hong, Je Rak;Kim, She Young;Seo, Young Woo;Kim, Ji Su;Park, Han Sol;Lee, Min ho;Kim, Tae Hun;Kim, Kiok
    • The Journal of Korean Medicine
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    • v.37 no.2
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    • pp.93-103
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    • 2016
  • Objectives: The purpose of this study was to report Four cases of Failed Back Surgery Syndrome (FBSS) patients after spinal fusion surgery who showed significant improvement in pain and function with Complex Korean medical treatment. Methods: This study was a retrospective observational study. We reviewed medical records of Four patients with lumbar pain or radiating leg pain, who have received spinal fusion surgery in the past. All Four patients took complex treatments of Mokhuri Neck and Back hospital which involes Acupuncture, Pharmaco-acupuncture, Gangchuk herbal medicine, Chuna and Physical therapy during about four-week of admission treatment. Visual Analogue Scale (VAS), Oswestry disability index (ODI), Pain Free Walking Distance (PFWD) scores were assessed before and after treatments. Results: The average of hospitalization period was 28.5 days. Mean VAS scores decreased from 6.5 to 2.3, Oswestry Disability Index (ODI) scores decreased from 56.25 to 38.25 and Pain Free Walking Distance (PFWD) also improved from 10m to 166.6m. Conclusion: This study implies that a combination of Korean medical treatments might be effective in relieving pain, and improving the functional status of FBSS patients. Further studies are needed to fully understand the mechanisms underlying the effects.

Reliability and Validity of the Measurement of Pelvic Movement in Low Back Pain Patients using Cushion Sensor in Sitting Position (앉은 자세에서 방석센서를 이용한 요통환자 골반가동성 측정의 신뢰도와 타당도)

  • Jung, Seung-Hwa;Park, Dae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.2
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    • pp.83-91
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    • 2020
  • PURPOSE: Postural and structural asymmetry due to muscle imbalances around the lower back and pelvis are the causes of back pain. Muscle imbalances in patients with chronic low back pain affect the pelvic tilt and movement, and it is necessary to assess the pelvic movement ability using the appropriate tools to determine the mediating effects of lower back pain. This paper reports the reliability and validity of the Sensbalance Therapy Cushion (STC) for pelvic movement and proprioception. METHODS: In this study, the Wii balance board (WBB) was used as a golden standard for pelvic movement measurements. FABQ, KODI, Myovision, and Pelvic movement were measured in 50 patients with chronic low back pain. The correlation between the lower-back muscle activity and pelvic movement was checked. The pelvic movement parameter was measured twice to determine the intra-rater reliability. RESULTS: The STC showed high test-retest reliability in the pelvic tilt measurements (ICC = .672 - .809). The test-retest reliability of proprioception measurements (ICC = .588 - .859) and reaction time measurements (ICC = .542 - .836) were also high. The relationship between the WBB and STC showed a significant positive correlation with the pelvic tilt test (p < .01). The posterior pelvic tilt and lower-back muscle activity showed a significant negative correlation (p < .01). The pelvic left tilt and lower-back muscle activity showed a significant negative correlation (p < .05). CONCLUSION: The results revealed the high reliability and validity of the STC. Therefore, the STC can be used as an objective measuring device for evaluating pelvic tilt, proprioception, and reaction time in low back pain patients.

The Effect of Lumbar Medial Branch Block on Low Back Pain

  • Kim, Kyoung-Tae;Park, Seung-Won;Kim, Young-Baeg;Hong, Hyun-Jong;Kwon, Jeong-Taik;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.256-261
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    • 2006
  • Objective : The goal of this study was to establish the benefit and prognostic factors of lumbar medial branch block[MBB] for low back pain. Methods : A retrospective analysis was based on the data obtained from 281 patients with low back pain, who visited our hospital between January 2001 and November 2004. Pain relief was evaluated at 2 weeks, 1 month and 3 months. The authors analyzed the results of MBB according to the patient's age, sex, symptom duration, pathologic condition, and presence of radiating pain. Results : Two hundred eighty one patients had sprain [151]. lumbar fracture [27], spinal stenosis [50], herniated lumbar disc [24] acute post-operative pain [8], and chronic post-operative pain [21] with success rate of 63.6%, 59.3%, 26.0%, 25.0%, 87.5% and 42.9%, respectively. The effects of MBB in sprain, lumbar fracture, and acute post-operative pain were significantly better than those in stenosis, herniated lumbar disc and chronic post-operative pain patients. The patients in young age group [<60 years], with short symptom duration [<6 months] and without radiating pain showed good response to lumbar MBB. Conclusion : The lumbar MBB appears to be safe and effective for low back pain in certain selected patients. Good prognostic factors were low back pain without surgical conditions and radiating pain, with short symptom duration [<6 months], and in relatively young age [<60 years] group.

The Effects of Integrating Vibration Into Stabilization Exercise on Balance and Disability in Patients With Chronic Low Back Pain (진동자극 환경에서의 요부 안정화 운동이 만성요통환자의 균형능력 및 기능장애수준에 미치는 영향)

  • Son, Chang-hwan;Moon, Young;Choi, Jong-duk
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.19-27
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    • 2019
  • Background: Compared to healthy people, patients with chronic lower back pain have reduced balance abilities which may cause proprioception problems, patients with chronic lower back pain avoid physical activities due to pain, and reduced activity levels lead to muscle weakening, which can further exacerbate pain. Recently, there have been many studies on the use of sensory stimulation; and among these studies, interventions that use vibrational stimulation have shown functional improvements in the patients. Objects: This study examined the effects of a stabilization exercise with vibration stimulation on the balance ability and disability in patients with chronic back pain. Methods: The subjects of the study were 30 persons who were randomly assigned to the experimental group and the control group, with 15 subjects in each. The subjects were evaluated before and after intervention via a balance ability test, the Korean Oswestry disability index (KODI) test, a pain test, and a proprioceptive sensory test. Both groups received general physical therapy. The experimental group performed the stabilization exercise with vibration stimulation, and the control group performed a general stabilization exercise, three times a week for six weeks. Results: After the intervention, both groups showed significant improvements in the balance ability test, the KODI test, the pain test, and the proprioceptive sensory test. The experimental group showed statistically significant, higher improvements than the control group in the balance ability test, the KODI test, and the proprioceptive sensory test. Conclusions: The stabilization exercise with vibration stimulation for patients with chronic back pain has been reported to provide greater functional improvements than the conventional intervention method. Therefore, the stabilization exercise in a vibration stimulation environment could be a useful intervention for patients with chronic back pain.

Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians

  • Jain, Anuj;Agarwal, Anil;Jain, Suruchi;Shamshery, Chetna
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.368-373
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    • 2013
  • Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain

  • Semeru, Gracia Mayuni;Halim, Magdalena S.
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.22-29
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    • 2019
  • Background: The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. Methods: A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). Results: This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. Conclusions: This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.