Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.
The purpose of this study was to investigate the correlations between pain intensity, physical impairments, disability, and psychological factors according to the difference in duration of low back pain. This study was a cross-sectional survey of 102 participants with low back pain, divided into two groups equal in number: The first group consisted of patients with acute and subacute low back pain, while the second group consisted of patients suffering from chronic low back pain. The results showed that gender, age, pain intensity, physical impairment, disability and Fear-Avoidance Beliefs (FABs) for work activities were not significantly different between two groups. FABs for physical activities of the first group were significantly more prevalent than in the second group. More than moderate correlations were found between pain intensity, physical impairment, and disability in the first group. Less than moderate correlations were found between pain intensity, physical impairment, disability, FABs, and depression in the second group. These findings suggest that we must consider psychological factors in the treatment of patients with chronic low back pain. Regression analyses revealed that pain intensity and FABs for work activities significantly contributed to the prediction of disability in the first group. Also, pain intensity and FABs for physical activities significantly contributed to the prediction of disability in the second group. Pain intensity was most important predictor of disability in two groups.
Psychsocial factors appear to play an important role in the maintenance and development of chronic disability from low back pain. Fear of pain may be more disabling than the pain itself in patients with nonacute low back pain. The purpose of this study was to identify the contribution of gender, age, depression and pain-related fear to pain intensity and disability in nonacute low back pain patients. This was a cross-sectional survey study of eighty four patients who had low back pain for at least 4 weeks. More than moderate correlations were found between pain intensity, disability, fear-avoidance beliefs and depression. Regression analyses revealed that disability ratings and fear-avoidance beliefs for work activities significantly contributed to the prediction of pain intensity, even when controlling for age, gender and pain duration. Also, fear-avoidance beliefs for physical activity, pain intensity, age and depression, significantly contributed to the prediction of disability, even when controlling for gender and pain duration. These findings suggest that disability scores and fear-avoidance beliefs for work activities are important determinants of pain intensity. They also suggest that fear-avoidance beliefs for physical activity, pain intensity, age and depression are important determinants of disability.
The purpose of this study is to analyze the phases of back pain occurring on pregnant women, and to raise the necessity of the pain management on the basis of the former analysis. The objective group is 284 pregnant women who visited department of OBGY of hospital located both in Seoul and Andong. The results are as follows; 1. 204(71.8%) pregnant women were suffering from back pain. The ratio of pain occurrance in terms of the duration of pregnancy shows that 78.3% within 3 pregnant months, 68.4% between four and six months and 72.1% over seven month. Most common ares of pain was low back area rating 60.5%. 2. The most painful postural for the suffering women was lying on the back rating 35.9% and the next painful posture was standing rating 34.4%. And the most painful movement was to maintaining continues movement(57.8%). Twisting back rates the second(17.2%). These two variables were relevant each other(p<0.05). 3. 46.7% of pregnant women were experiencing nocturnal pain. Among women experienced the pain before pregnancy, 39.9% were suffering during the pregnancy. The occurrence of nocturnal pain was related to the pain before and after the pregnancy(p<0.05). 4. 58.8% of pregnant women who experience back pain take the pain for granted as a normal proceeding of pregnancy while 3.9% recognize the symptom as an abnormal. Pain recognition in accordance with the phases does not show much difference(p<0.05). 5. It is shown that the more one delivers the number of babies, the faster back pain occurs(p<0.01). 6. 32.3% of the pain-suffering women have family member(s) having back pain. Family member(s) of the women who does not experience the pain don't have the pain either. This case reports 46.1%. Statistically, these two variables are relevant(p<0.01). 7. 43.0% of back pain experiencing women does not have any particular management plan against the pain. 20.7% is exercising as for prevention. Women who recognize the necessity of some means of therapy for their pain marked 42.9%. The majority(65.8%) of women responded exercise gymnastic work-out are most appropriate pain management. The above results show that a great number of pregnant women is experiencing back pain, however, they properly managed. This span suggests that appropriate advocacy and education for pregnant women is necessary. It is recommended that positive contribution can be made to better health of pregnant women when pain management by physical therapist is given.
Background: The purpose of this research was to investigate the factors affecting the low back pain of workers in hospital. 214 subjects waking at two general hospitals in Yosu city participated in this survey. Subjects consisted of doctors, nurses, medical engineers, officers and general laborers. The survey data were collected by a written questionnaire which made out by themselves for 25 days, from fourth August to 29th August, 2008. Methods: The questionnaire consisted of four categories, general, occupational, working habitual and the daily living characteristics. The collected data were analyzed by Chi-square test based on the present or absent of low back pain. Results: 1. In the general characteristics, low back pain had no significant relationship to all factors, sex, ago, body mass index, weight and height. 2. In the occupational characteristics, the phase of distribution of low back pain had statistical significant differences in the working hours a week, satisfaction of pay, satisfaction of occupation(p<0.05). However low back pain did not significantly related to the kind of occupation, period of work and degree of stress. 3. In the habitual characteristics, low back pain was significantly influenced by working posture, frequency of using lumbar and heavy material lifting, monotonous repetition of working operation and noise(p<0.05). No significant difference was shown in the factor of convenience of chair. 4. In the daily living characteristics, low back pain shown the significant differences in walking time a day, status of health and smoking pattern(p<0.05). there were, however, no significant differences in the aspect of the kind of house and bed, sleeping attitude, driving, riding time on the vehicle, exercising, frequency of cultural life and drinking alcohol. Conclusion: when I see above resultants totally, it appears a higher incidence caused by working environment rather than living habit and then consequently compared to hospital workers, they also have high incidence like others. In order to reduce incidence of low back pain and enjoy the our life we need to educate ourselves preventing program for low back pain and try to effort for preventing of low back pain on each department and individual.
Low back pain patients and controls of shipyard workers were surveyed between June 1995 and September 1995 to identify risk factors of industrial low back pain. The patients were 17 male workers who had got medical treatment for over 3 days because of industrial back pain. Controls were 51 male workers who had not have musculoskeletal disorder for one year before the survey. By univariate analysis, the workers who did overtime work 4 times or more for the last 2 weeks showed odds ratio of 3.67 on low back pain with the workers who did less overtime work. Carrying heavy materials was also associated with the low back pain and the odds ratio increased with the increase of carrying weight. Work space and work posture were not associated with the low back pain significantly. The welder had higher odds ratio than the other workers on low back pain. The duration of employment and job satisfaction did not affect the risk of low back pain. Multiple logistic regression analysis showed that frequency of overtime work for the last 2 weeks and carrying heavy materials among the risk factors were associated significantly with the low back pain. We found that important risk factors of low back pain of shipyard workers are work intensity factors such as overtime work and carrying heavy weight.
Even though back pain therapy has greatly improved as spinal bio-mechanics is introduced, many patients still have difficulties due to low back pain. At the initial therapeutic stage, the aim of rehabilitation therapy for low back pain is pain control, but, at the later therapeutic stage, the prime aims are to reduce the late complication and to prevent the recurrence of low back pain. Accurate diagnosis should be a first step before any therapy is planned. Thus, accurate physical, neurologic, E.M.G. and radiologic tests are required to give prescription for therapeutic exercise to the patients. In addition to this, the roles of theraphists and therapeutic exercise should be re-evaluated after the therapeutic exercise is performed. Fist of all, the most important things are to educate the patients to understand the low back pain and to let the patients join the therapeutical planning. 1. Bed rest and muscle relaxing exercise for releasing the muscle tention are required for the treatment of acute low back pain. An active exercise is recommended rather than a passive exercise. If the therapeutic exercise depravate the low back pain, the exercise should be immediately terminated and the therapeutical exercise should be replanned. 2. For the treatment of the chronic back pain, stretching exercise and para-spinal muscle strengthening exercise should be performed steadily and actively to prevent the recurrence of low back pain and the low back injury due to minor damage. The patients should be educated to do proper exercise and to maintain good posture in everyday life. 3. As the low back pain is released and the body function is recovered, control of whole body function is necessary. Swiming, bicycling and walking for $30\sim40$ minutes a day and $3\sim4$ days a week are recommended. Other exercise could be recommended depending on the patients condition.
Objectives : The purpose of this study is to set up the standard for Classification and Diagnosis of Low Back Pain by through collecting bibliographic study on Low Back Pain and related general symptoms in classical literatures Methods : We investigated the contents of classical literatures about chronic low back pain and related general symptoms. With this contents, we established a systemic classification and diagnostic standard for Low back pain. Results : There are many different opinions on classification of low back pain and general symptoms in oriental medicine classical literature. Every opinion is reasonable, so it is difficult to establish a diagnosis of Low back pain. But it is necessary to set up the one-systemic classification and diagnostic technique of Low back pain. Conclusions : We conclude that the Ten type Low back pain classification of in Dong-Eui-Bo-Gam is a reasonable standard for diagnostic classification.
Purpose: The purpose of this study was to identify effects of a strengthening program for the lower back in older women with chronic low back pain. Methods: The research design was a nonequivalent control group pretest-posttest experiment. The experimental group consisted of 16 older women and the control group, 14, all of whom had experienced low back pain for at least 3 months. The strengthening program for the lower back included lumbar stabilization exercises and education on pain management in daily living. For an 8 week period, exercises were done 3 days a week and on one day education was also given. Results: Pain and disability scores decreased significantly in the experimental group compared to the control group. Flexibility, life satisfaction and lumbar muscle strength scores increased significantly in the experimental group compared to the control group. Conclusion: Low back pain and disability can be relieved, and flexibility, muscle strength, and life satisfaction increased through a program to strengthen the lower back. It is suggested that a program to strengthen the lower back would be an effective nursing intervention for older women with low back pain.
Objective : The purpose of this study is to estimate the effects of spiral taping treatment on low back pain. Methods : 420 low back pain patients were treated with spiral taping or spiral taping plus herbal medicine, and no other treatments such as acupuncture, herbal acupuncture, and chiropractic therapy were added. We evaluated the improvement by physical examination and pain. Results : 364 patients felt no pain or inconvenience of daily life and 43 patients showed improvement of pain or symptom after 1 month of treatment. 13 patients showed same pain with before treatment. Conclusion : These results suggest spiral taping treatments contribute to the improvement of low back pain. Further study is needed for the confirmation of this effect of spiral taping treatments on low back pain.
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