• Title/Summary/Keyword: Chronic Low Back Pain

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The Effects of Lumbar Stabilization Exercise on Muscle Activity and Isokinetic Muscle Strength of Female Patients with Chronic Low Back Pain (요부안정화 운동이 만성요통여성 환자의 근활성도와 등속성 근력에 미치는 영향)

  • 방현수
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.2
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    • pp.63-71
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    • 2015
  • PURPOSE: The purpose of this study to investigate the effects of exercise on lumbar stabilization in muscle activity and isokinetic muscle strength of female with chronic low back pain. METHODS: The candidates was chose to twenty women in their 30s and 40s complaining back pain for over 12 weeks and consist of 10 people for lumbar stabilization and general physical therapy group(PL group), another 10 people for general physical therapy group(GP group). Lumbar stabilization exercise was conducted for 8 weeks and was comprised of 60 minutes for two times a week. In order to examine the effects of lumbar stabilization, results in the present study were analyzed maximal voluntary isometric contraction (MVIC) using electromyogram to measure muscle activity and isokinetic performance including peak torque and average power at the pre to post. RESULTS: The following are results in this study. The MVIC and isokinetic muscle strength were gradually increased in all group. As the result of the test of the MVIC and isokinetic muscle strength, the difference of lumbar stabilization and general physical therapy group is statistically more significant than that of general physical therapy group. CONCLUSION: In the present study, results indicate that lumbar stabilization helps to improve the muscle activity and isokinetic muscle strength.

Recalcitrant Low Back Pain Diagnosed as Hypophosphatemic Osteomalacia Induced by Antiviral Medication (항바이러스제에 의한 저인산성 골연화증으로 진단된 난치성 요통)

  • Chae, Hyun Jun;Won, Jun Hee;Lee, Won Kyung;Kim, Keewon
    • Clinical Pain
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    • v.20 no.2
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    • pp.131-134
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    • 2021
  • We report a rare case of anti-viral agent induced hypophosphatemic osteomalacia presented with localized and radicular pain. A 51-year-old man, who had been taking adefovir for chronic hepatitis, had experienced low back pain radiating to his right thigh for 2 years. With impression of lumbar disc herniation, he underwent magnetic resonance imaging and found multi-level disc herniation with facet joint synovial cysts. He received transforaminal epidural steroid injections, however, symptoms did not improve. To find other possible causes, additional tests were performed. Blood tests revealed hypophosphatemia and increased serum alkaline phosphatase, and osteoporosis was noted in dual-energy X-ray absorptiometry with multiple hot uptakes in bone scan. After replacement of adefovir to entecavir and supplement of phosphate and vitamin D, phosphate level and the clinical symptoms were improved. This is the first to report the presentation of osteomalacia due to anti-viral agent as radicular low back pain with facet synovial cysts.

Spinal Joint Pain Syndrome (척추관절통증증후군)

  • Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.1-10
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    • 2008
  • Spinal joint pain syndrome is composed of atlanto-occipital, atlanto-axial, facet, and sacro-iliac joints pain. The syndrome is characterized as referred pain which is originated from deep somatic tissues, which is quietly different from radicular pain with dermatomal distribution originated from nerve root ganglion. The prevalence of facet joint pain in patients with chronic spinal pain of cervical, thoracic, and lumbar regions has been known 56%, 42%, and 31% as in order. It is generally accepted in clinical practice that diagnostic blocks are the most reliable means for diagnosing spinal joints as pain generators. The sacroiliac joint has been shown to be a source of 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. The treatment of spinal joints ideally consists of a multimodal approach comprising conservative therapy, medical management, procedural interventions, and if indicated.

The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients (급성 및 만성 요통환자의 요부주위근 횡단면적과 요통 예후의 상관관계 연구)

  • Nam, Ji Hwan;Lee, Chong Hwan;Lee, Seul Ji;Kim, Kie Won;Lee, Min Jung;Jun, Jae Yun;Lim, Su Jin;Hong, Nam Jung;Song, Ju Hyun
    • Journal of Acupuncture Research
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    • v.30 no.4
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    • pp.45-53
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    • 2013
  • Objectives : The purpose of this study was to evaluate the relationship between cross-sectional areas of the paraspinal and psoas muscles with low back pain. Methods : We assessed the cross-sectional area of the psoas and paraspinal muscles at the superior part of L4 level and vertebral body of L4 of 132 patients who were hospitalized with a chief complaint of low back pain at Jaseng Hospital of Korean Medicine from January 2013 to April 2013. After calculating the mean psoas area, we divided the patients into 2 groups by whether the psoas cross section was larger or smaller than the mean, and compared the admission period, verbal numeric rating scale(NRS) of low back pain(LBP), and improvement of verbal NRS of LBP. We also subcategorized the patients into acute and chronic groups according to the duration period, and compared the cross-sectional area of the psoas and paraspinal muscles. Results : Although analyses of the verbal NRS of LBP, and improvement of verbal NRS of LBP between groups with larger and smaller psoas cross section areas showed no significant difference, the admission period was significantly shorter in the group with larger psoas cross section areas. There was no significant difference in analyses of cross section areas in the acute and chronic groups. Of the possible prognostic variables, improvement of verbal NRS of LBP showed no correlation, while the admission period displayed a significant correlation. The cross-sectional area of the psoas and paraspinal muscles divided by the area of the vertebral body of L4 had a significant negative correlation with age. Conclusions : The cross-sectional area of the psoas and paraspinal muscles were correlated with the admission period in LBP patients, and the cross-sectional area of the surrounding muscles divided by the area of the L4 vertebral body was negatively correlated with age.

Mediating Effect of Coping Strategies in the Relationship between Pain Beliefs and Depression, Pain Disability among Chronic Back Pain Patients (만성요통환자에서의 통증신념과 우울, 통증생활방해와의 관계에서 대처전략의 매개효과)

  • Kim, Kyoung-A;Chu, Sanghui
    • The Journal of the Korea Contents Association
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    • v.17 no.10
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    • pp.206-215
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    • 2017
  • The Purpose of this study was to investigate of coping strategies(active and passive) between pain beliefs and depression, pain disability among chronic back pain patients. Data were analyzed by the SPSS-WIN 21.0 program. Indirect SPSS macro(Bootsrapping)was used to analyze the multiple-mediation model of this study. The result showed that the mean score for pain belief was $3.42{\pm}9.67$, and he passive coping strategies was $29.68{\pm}8.04$, active coping was $25.49{\pm}4.22$. The mean score of depression was $25.49{\pm}11.56$. The pain disability index was $46.94{\pm}12.65$. It found that there were significant correlations among the 5 variables. The multiple mediated effects of passive coping and active coping on pain beliefs and depression were (b=.453, 95% CI=.228, .703) and on pain beliefs and pain disability were (b = .285, 95% CI = .131, .519) in chronic low back pain patients. This study discovered that the active coping strategies had a positive mediating effect in the relationship between pain beliefs and depression, pain beliefs and pain disability. And passive coping strategies had a negative mediating effect. Based on findings of this study, improving the active coping strategy programs or management is highly recommended in chronic back pain patients.

Etiopathogenesis of sacroiliitis: implications for assessment and management

  • Baronio, Manuela;Sadia, Hajra;Paolacci, Stefano;Prestamburgo, Domenico;Miotti, Danilo;Guardamagna, Vittorio A.;Natalini, Giuseppe;Bertelli, Matteo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.294-304
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    • 2020
  • The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.

Effects of Lumbar Stabilization Exercise using PNF Techniques on Thickness of Lumbar Deep Muscle and Functional Activity in Chronic Low Back Pain Patients (만성요통환자에서 PNF 기법을 이용한 요부안정화 운동이 요부 심부근 두께 및 기능적 활동에 미치는 효과)

  • Kim, Gi-Do;Lee, Yun-Jung;Choi, Wan-Suk;Lee, Dong-Woo;Jung, Dae-In;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.3
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    • pp.233-243
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    • 2012
  • The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

Effects of Local and Sa-am Acupuncture on Hypoadrenia and Chronic Low Back Pain (신정격(腎正格) 침치료와 요추부 국소 침치료가 신허요통(腎虛腰痛)에 미치는 유효성 비교평가)

  • Kim, Seoung-Min;Kim, Ho-Jun;Lee, Myeong-Jong;Shin, Young-Jin
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.104-116
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    • 2009
  • Objectives: This experimental study was designed to show the relationship between kidney qi deficiency and hypoadrenia. A comparative study between Sa-am and local area acupuncture stimulation was conducted. The test results help to show the relationship between kidney qi deficiency and hypoadrenia as well as the recuperation of the patient with the use of VAS, ROM, Sch ber test, ODI and salivary cortisol testing. Methods: 1. Twenty-four adults with chronic low back pain were recruited. Once selected the test population was divided into two different groups. One group was treated only with the use of local area acupuncture and the other with Sa-am acupuncture. 2. At the completion of each acupuncture treatment both groups underwent a VAS, ROM, ODI, $Sch{\ddot{o}}ber$ Test and salivary cortisol test. Results: 1. Both the Sa-am acupuncture group and the local area acupuncture group had statistical significance in VAS decrease and flection ROM increase. 2. Only the Sa-am acupuncture group had statistical significance in extension ROM increase. Only the local area acupuncture group had statistical significance in both lateral flection ROM increase and ODI test. 3. There was statistical significance of correlation between morning salivary cortisol test and adrenal fatigue questionnaire. Conclusions: Both local area acupuncture as well as Sa-am acupuncture treatments were effective for treating lower back pain caused by kidney qi deficiency. In addition, each patients recuperation level can be verified with the results seen from the salivary cortisol test results. The cortisol results suggest a similarity between kidney qi deficiency and hypoadrenia.

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Comparison of the Balance Relations Between Healthy Subjects and Patients With Chronic Low Back Pain (만성 요통환자와 정상인의 균형반응 비교)

  • Yang, Hoi-Song;Lee, Kang-Woo
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.1-17
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    • 2002
  • The purpose of this study was to identify the differences of the static and the dynamic balance reactions in the flexion syndrome (FS) and the extension syndrome (ES) group of the patients with chronic lowback pain (LBP) and healthy subjects. Twenty subjects were included in each group. By using EquiTest 5.02, the static balance was measured by the equilibrium score and the strategy score of sensory organization test (SOT), while the dynamic balance was measured by the latency of motor control test (MCT) and the sway energy of adaptation test (ADT). Oswestry Disability Index (OSI) was used to measure level of the disability in patients with chronic LBP. The equilibrium scores, the strategies of SOT, and thelatencies of MCT of three groups were compared with one way ANOVA, while the sway energy of ADT was compared with repeated measures one way ANOVA. The results of this study showed that the equilibrium scores and the strategy scores of SOT were significantly lower in patients with chronic LBP than in healthy subjects. The equilibrium scores and the strategy scores of SOT were significantly differences between the FS and ES groups in condition 5 (support surface was sway-referenced and visual information waseliminated by eye closure), and 6 (support surface was sway-referenced and visual information was altered by sway-referencing). The FS group showed delayed average reaction time at large posterior translation, however, the ES group showed delayed average reaction time at large anterior translation, Even though the sway energy of the patients with chronic LBP were greater than that of healthy subjects during the toe down (plantar flexion rotation), the values between the FS and ES groups didn't show any significant difference. The disability level showed highly correlation with the equilibrium score of the condition 5. As the results, the FS and ES groups divided by the their symptoms and signs in patients with chronic LBP showed different balance reaction. Therefore, more accurate evaluation and balance treatments are needed to focus on their symptoms and signs in patients with chronic LBP.

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The Effects of Joint Mobilization and TENS on Pain Threshold and Hormonal Changes in Patients with Chronic Low Back Pain (관절가동술과 TENS가 만성요통환자의 통증역치 및 호르몬 변화에 미치는 영향)

  • Lee, Seung-byung;Jeong, Seong-gwan;Lee, Ho-jun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.26 no.1
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    • pp.65-72
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    • 2020
  • Background: The purpose of this research is to investigate the effects of joint mobilization and transcutaneous electrical nerve stimulation (TENS) on pain threshold and hormonal changes in patients with chronic LBP. Methods: 14 patients with chronic LBP were divided into the experimental group and the control group with 7 patients each, and both groups of patients were evaluated on pain duration, blood tests, and pressure pain threshold (PPT) on their first visit. On their second visit, joint mobilization was applied to the experimental group for 10 min and TENS to the control group for 20 min. Results: Pain threshold and duration of analgesia increased from after treatment in the experimental group. Serotonin and Cortisol decreased after treatment in the experimental group. Conclusion: Joint mobilization in patients with chronic LBP caused an increase in pain duration and pain thresholds and a decrease in serotonin, whereas there was little difference in cortisol.