• Title/Summary/Keyword: Chronic Low Back

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Low-Level Laser Therapy including Laser Acupuncture for Non-Specific Chronic Low Back Pain : Protocol for a Systematic Review

  • Yeum, Hyewon;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.251-255
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    • 2019
  • Background: Low-level laser therapy (LLLT) including laser acupuncture (LA) has been widely used to treat chronic low back pain (CLBP), but there is no critically appraised evidence of the potential benefits. The purpose of this protocol for a systematic review was to enable the evaluation of the effectiveness of LLLT including LA for non-specific CLBP to identify the potential benefits. Methods: The electronic databases MEDLINE (PubMed), Embase (Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), Korean medical databases (KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS), the Chinese database (CNKI), and Japanese databases (CiNII, J-STAGE) are recommended. Results: Randomized controlled trials in LLLT including LA should be included in the searches. All data synthesis and subgroup analyses should be conducted using a Review Manager software. The Cochrane risk of bias tool can be used to evaluate methodological quality of the studies. A risk ratio or mean difference with a 95% confidence interval will show the effects of LLLT including LA. Conclusion: The primary outcome would be pain intensity and functional status/disability due to low back pain. The secondary outcome would be a global measurement of recovery or improvement, quality of life and adverse event.

The Clinical Study on Effects of Moxa-pellet Therapy in Chronic Low Back Pain Patients (만성요통(慢性腰痛) 환자(患者)에 대한 압봉료법(壓蓬療法)의 임상적(臨床的) 관찰(觀察))

  • Ko, Young-Jin;Lee, Ro-Min;Kim, Joo-Hee;Nam, Sang-Su;Kim, Chang-Hwan
    • Journal of Acupuncture Research
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    • v.24 no.3
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    • pp.187-196
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    • 2007
  • Objectives : This study was designed to evaluate the effect of Moxa Pellet therapy on chronic low back pain. Methods: Subjects were voluntarily recruited by newspapers and internet. The Moxa Pellet therapy was performed for 4 weeks. Patients were randomized to three groups: Moxa Pellets, Control-l and Control-2 group. Moxa Pellets group administered with Moxa Pellets, Control-l group administered with moxa pellet-shaped moxa pellet without available components and Control-2 group administered with round bonded fabric that could not give pressing stimulation. Acupuncture points used in this study were $GV_3$, $BL_{23}$, $BL_{24}$, $BL_{25}$ and $BL_{22}$. The patient's symptoms were assessed before and after 4 weeks treatments by VAS, SF-MPQ and SF- 36. Results : The results are follows; 1. VAS score showed significant difference in Moxa Pellet group and Control-l group after treatment. 2. SF-MPQ score showed significant difference only in Moxa Pellet group. 3. Moxa Pellet group showed significant difference in PF, RE, MR, and BP of SF- 36 score after treatment; Control-l group showed no significant difference; Control-2 group showed significant difference in BP. There were no significant difference among the groups. Conclusions : This study suggests that Moxa Pellet therapy can be applicable to improve symptoms in the patients with chronic low back pain. Further studies on the Moxa Pellet therapy and other treatment in the patients with chronic low back pain is recommended.

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Analysis of the Efficacy of Acupuncture for Chronic Low Back Pain Based on the Relationship Between Trunk Flexors and Extensors (요부 굴곡과 신전운동의 관점에서 분석한 만성요통의 침치료 효과)

  • Kim, Eu-Gene;Park, Won-Hyung;Cha, Yun-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.557-565
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    • 2012
  • The purpose of this study was to examine the effect of acupuncture on trunk flexors compared with trunk extensors in patients with chronic low back pain. The experimental group was treated with acupuncture on trunk flexors. The control group was treated with acupuncture on trunk extensors. Acupuncture treatment was performed 12 sessions over the course of 6 weeks. Volunteers who satisfied the requirements were enrolled in the study. Chronic low back pain was evaluated based on the VAS for bothersomeness, VAS for pain intensity at every treatment and 8, 12 and 24 weeks after starting the treatments, and ODI, SF-36 and BDI before and after treatments and 8, 12 and 24 weeks after starting the treatments. The VAS score for bothersomeness significantly decreased after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for bothersomeness in the experimental group decreased more rapidly than that of the control group with statistical significance (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI significantly improved after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI in the experimental group showed more rapid improvement than those of the control group. But, there were no statistical significances. Treating trunk flexors using acupuncture was more effective in decreasing the degree of bothersomeness caused by chronic low back pain than treating trunk extensors with acupuncture. There is a need to perform further studies.

The Effects of Contract Relaxation and a Combination of Isotonics on the Hip and Lumbopelvic Motions in Patients with Chronic Low Back Pain (만성 요통 환자에게 수축 이완과 등장성 수축 결합이 엉덩관절과 허리골반 움직임에 미치는 영향)

  • Kim, Chi-Hwan;Lee, Ju-Hun;Han, Jin-Tae
    • PNF and Movement
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    • v.19 no.1
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    • pp.43-55
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    • 2021
  • Purpose: The purpose of this study was to determine the effects of contract relaxation and a combination of isotonics in proprioceptive neuromucular facilitation (PNF) on hip and lumbopelvic motions of male patients with chronic low back pain. Methods: As the subjects of this study, a total of 45 male patients with chronic low back pain were divided into groups: 15 who underwent contract relaxation (CR) of the PNF of their hip joints, 15 who underwent a combination of isotonics (CI) of the PNF, and 15 who underwent both techniques. A device for analyzing three-dimensional motion was used to measure hip medial rotation angles, lumbopelvic rotation angles, and hip medial rotation angles at the start of lumbopelvic rotation during hip medial rotation. A two-way repeated measures ANOVA was used to compare the average values. Results: There were interactions in the hip medial rotation angles, lumbopelvic rotation angles and hip medial rotation angles at the start of lumbopelvic rotation based on the methods and periods of exercise (p < 0.05). The CR and the CR+CI groups displayed more increased hip medial angles when compared to the CI group. The CR+CI group had more decreased lumbopelvic rotation angles when compared to the CR and the CI groups. The CR+CI group had more increased hip medial rotation angles at the start of lumbopelvic rotation when compared to the CR and the CI groups. Conclusion: It can be concluded that the combination of stretching and stability exercises was effective in male patients with chronic low back pain who showed limited hip medial rotation.

The Short Term Effects of the Decompression (KNX $7000^{(R)}$) and Traction Device on Pain in Patients with Chronic Low Back Pain with or without Radicular Pain (만성 요통 및 하지방사통 환자에서 감압치료(KNX $7000^{(R)}$)와 견인치료의 단기 치료 효과)

  • Park, So-Hyun;Kim, Chul-Seoung;Lee, Dong-Gyu;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.23 no.5
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    • pp.29-34
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    • 2011
  • Purpose: The purpose of this study is to evaluate the short term effects of the traction and decompression device, which is a newly developed domestic medical device, on pain and functional activity in patients with chronic low back pain with or without radicular pain. Methods: Forty patients with chronic low back pain were included and allocated to decompression (n=20) and traction groups (n=20). They received decompression or traction therapy for 20 minutes a day, 3 days per week for two weeks. For evaluating pain and functional activity, a visual analogue scale (VAS) for low back pain and the Oswestry back pain disability index (ODI) were obtained on pre-treatment, and at 6, 12 and 15 days after treatment. Patients'satisfaction levels were measured 15 days after treatment. Results: VAS was significantly decreased at 12 days and 15 days post-treatment compared to pre-treatment in both groups (p<0.05). ODI was significantly decreased at 12 days and 15 days post-treatment compared to pre-treatment in the decompression group (p<0.05). However, there was no significant difference between the two groups in the VAS and ODI scales (p>0.05). Patients' satisfaction levels were significantly higher in the decompression group than in the traction group (p<0.05). Conclusion: These findings suggest that decompression therapy might be effective for increasing functional activity in patients with low back pain and could provide patients with higher satisfaction than traction therapy. This study provided validity data for the therapeutic effects of the decompression device in patients with low back pain and it will be useful for medical cost development and patient education of this device.

Effectiveness of Proprioceptive Neuromuscular Facilitation of Chronic Low Back Pain -A Systematic Review and Meta-analysis of Studies in Korea- (만성허리통증의 고유수용성신경근촉진법 효과 -국내연구의 메타분석과 체계적 고찰-)

  • Kim, Beom-Ryong;Kang, Tae-Woo
    • PNF and Movement
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    • v.17 no.1
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    • pp.157-166
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    • 2019
  • Purpose: This study compares and examines the effects of proprioceptive neuromuscular facilitation (PNF) on patients with chronic low back pain through systematic literature review and meta-analysis. Methods: Domestic literature was searched with combinations of keywords including "proprioceptive neuromuscular facilitation," "PNF," "back pain," and "low back pain" using the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korean Medical Database (KMbase). Six studies (n=148) were finally included in the analysis through a selection and exclusion process. The quality of the studies was evaluated using the PEDro scale. Results: According to the meta-analysis results, the low back pains of the PNF group and the contrast group showed a standardized mean difference (SMD) of 2.21 (95% CI: -3.35, -1.07, p=0.01, $I^2=83%$) after intervention. Thus, the PNF group showed a statistically significant decrease in low back pain compared with the control group. In addition, the SMDs of the Oswestry Disability Index (ODI), lung function, and the Roland and Morris Disability Questionnaire (RMDQ) were -1.34 (95% CI: -1.88, -0.79, p<0.01, $I^2=35%$), 1.14 (95% CI: 0.49, 1.79, p=0.01, $I^2=0%$), and -1.59 (95% CI: -2.56, -0.62, p=0.01, $I^2=46%$), respectively. Thus, the PNF group showed statistically significant differences from the control group. Conclusion: At present, there is some limit to obtaining definite results about effect sizes because there are relatively few randomized controlled experiments that analyze the effects of PNF exercise in patients with chronic low back pain. Therefore, continuous efforts should be made to conduct randomized clinical trials and long-term efficacy studies in the future.

Comparison of the Relationship Between Impairment, Disability and Psychological Factors According to the Difference of Duration of Low Back Pain (요통기간에 따른 손상, 장애, 심리적 요인들의 상관성 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.76-84
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    • 2011
  • 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.

Nicotine dependence and the International Association for the Study of Pain neuropathic pain grade in patients with chronic low back pain and radicular pain: is there an association?

  • Schembri, Emanuel;Massalha, Victoria;Spiteri, Karl;Camilleri, Liberato;Lungaro-Mifsud, Stephen
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.359-377
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    • 2020
  • Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

Treatment of Failed Back Surgery Syndrome with a Spinal Cord Stimulator -A report of 2 cases- (척추수술후증후군에서 척수자극술을 이용한 치료경험 -증례 보고-)

  • Park, Chan Hong;Cho, Chul Bum
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.123-126
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    • 2006
  • 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.

Comparison of the Effects of Spinal Manipulation Combined with Painkiller and Muscle Relaxant to Painkiller and Muscle Relaxant Alone on Pain, Lumbar Range of Motion, and Disability Index in Patients with Chronic Low Back Pain (진통제-근육이완제 복용 병행 척추교정과 진통제-근육이완제 복용이 만성허리통증 환자의 통증, 허리 관절가동범위, 장애 지수에 미치는 효과 비교)

  • Dong-Hwan Oh;Suk-Chan Hahm
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.33-45
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    • 2024
  • Purpose : This study aimed to compare the effects of spinal manipulation combined with medication on low back pain (LBP), range of motion, and disability in patients with chronic LBP. Methods : Twenty patients with chronic LBP were included in this study. The participants were randomly assigned to the spinal manipulation with medication group (n=10) or the medication only group (n=10). The intervention group received spinal manipulation for 15 minutes, twice a week, and took medication twice a day for eight weeks. The control group received the medication twice daily for eight weeks. Pain intensity assessed using the visual analog scale (VAS), range of motion, and disability due to LBP assessed using the Oswestry disability index were measured before and after the intervention. Results : The intervention group showed a significant improvement in pain intensity compared to the control group (p<.05), and the intervention and control groups significantly improved low back pain after the intervention (p<.05). The intervention group showed a significant improvement in the range of motion in flexion, extension, right lateral flexion, left lateral flexion, and right rotation (p<.05). The intervention group also showed a significant improvement in the change of disability in total score, pain intensity, personal care, lifting and standing compared to the control group (p<.05). Conclusion : This study showed that the combination of spinal manipulation and medication can benefit patients with chronic LBP, as evidenced by significant improvements in pain intensity, ROM, and disability. These findings suggest that utilizing both spinal manipulation and medication can positively affect individuals with chronic LBP. The results of this study should be applied in clinical settings to optimize treatment outcomes in patients with chronic LBP.