• Title/Summary/Keyword: Chronic Low Back Pain

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Pain Clinic 10 Years at Chonbuk National University (전북대학교 통증 치료실 10년)

  • Choe, Huhn;Oh, Kyoung-Hak;Song, Jeong-Ja;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.110-116
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    • 1995
  • The pain clinic at the Chonbuk National University Hospital opened in 1983. We analyzed 3,212 patients who visited the clinic during the 10 years from 1983 to 1993. The patients visited total of 11,628 times. The most frequent age group was in the fifties. About an half of the patients complained of low back pain, and the epidural block was most frequently given as a treatment. We need more personnels involving in pain management and more equipments in diagnosing and treating the patients with chronic pain. Understanding and cooperation among departments under the basis of closer interdepartmental relationship would be essential for the further development of the pain clinc.

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Lumbar Sympathetic Block for Spinal Cord Infarction Patient -A case report- (요부교감신경차단으로 척수경색 환자의 하지통증 치료 -증례보고-)

  • Kim, Dong Hee;Park, Sang Wook;Kim, Hyung Jee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.237-240
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    • 2006
  • This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.

Immediate Effects of Maitland Transverse Movement on Pain, Trunk Flexion Movement and Cobb's Angle in Patient with Upper Thoracic Scoliosis

  • Moon, Ok Kon;Choi, Wan Suk;Kim, Nyeon Jun
    • Journal of International Academy of Physical Therapy Research
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    • v.7 no.2
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    • pp.1066-1070
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    • 2016
  • The purpose of this article was to investigate the effects of Maitland's transverse movement on change of pain, trunk flexion movement and Cobb's angle in patient with upper thoracic scoliosis. The subject are 37 years old with chronic low back pain participated in this study and has no experience surgery within the last six months due to back pain. 10 set was applied 10 times on the T3-T5 applied the transverse movement with grade IV to each segment by skilled physical therapist. Transverse movement was applied convex toward the concave side. Pressure pain threshold was reduced from 4/10 to 2/10. Trunk flexion range that is the distance between the middle finger and floor was increase from 7.3cm to 2cm. Cobb's angle was decreased from degree 18 to 16. This result demonstrated that the Maitland's transverse movement was benefit to reduce the pain and Cobb's angle, and to increase the trunk flexion movement.

The effects of Moxibustion Therapy on Chronic Low Back Pain, Daily Living Disability and Sleep Pattern in Elderly Women (뜸요법이 여성노인의 만성요통, 일상생활기능장애 및 수면양상에 미치는 효과)

  • Kim, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.301-310
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    • 2016
  • This is a nonequivalent control group non-synchronized experiment research to verify the effect of moxibustion therapy on efficient management of daily living disabilities and sleep patterns in elderly women with chronic low back pain. Total 12 sessions of moxibustion therapy were applied to elderly women(30 subjects in an experimental group and 30 subjects in a control group) in G City once a week for 12 weeks from March 15th to May $31^{st}$ 2015. Then the follow-up study was conducted 2 weeks after the post survey. For moxibustion, was applied to Shen-shu, Ashi point, Ta chang shu, Yang kuan and Yosu. 5 sheets of moxibustion were applied to 7 acupuncture points of Mugeukboyang moxibustion; Zu san li & Chu chi, Chung wan, Chung chi & Shui tao, Fei shu, Kao hung and Tien shu, Wijung respectively and experimental treatment was conducted. For assessing the degree of back pain, Visual Analog Scale(VAS) developed by Scott & Huskisson(1979) was used and for measuring the degree of daily living disability, Oswestry Disability Index, which was developed by Fairbank et al(1980) and translated and revised by Yim, Hyeon-sul et al.(1998), was used. For measuring sleep patterns, the sleep pattern measurement tool developed by Oh, Jin-su, Song, Mi-soon and Kim, Sin-mi(1998) was used. For data analysis, SPSS/WIN 18.0 was employed and Chi-square test, t-test and repeated measures ANOVA were performed. There were significant differences in pain score(F=2510.32, p<.001), daily living disability score(F=1937.82, p<.001) and sleep pattern score((F=15.54, p<.001) of elderly women that were provided with moxibustion therapy, compared to the control group. Therefore, it was found that moxibustion therapy made a positive contribution to reduction in pain and daily living disabilities and improvement in sleep quality. Based on this study finding, there is a need to apply moxibustion therapy to elderly people with chronic low back pain as a nursing intervention in future.

Importance of an Integrated Assessment of Functional Disability and Work Ability in Workers Affected by Low Back Pain

  • Fabrizio Russo;Cristina Di Tecco;Simone Russo;Giorgia Petrucci;Gianluca Vadala;Vincenzo Denaro;Sergio Iavicoli
    • Safety and Health at Work
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    • v.15 no.1
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    • pp.66-72
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    • 2024
  • Background: This study examines the relationship between functional disability and work ability in workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data were collected during the first medical examination using anamnestic and clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the high school degree, 45.6% married. Results: WAI and ODI reported a negative and fair correlation (r = -0.454; p = .000). Workers with acute LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms. White collars without depressive symptoms reported higher work ability - even in chronic disability conditions-than those with depressive symptoms. Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study's findings highlight the importance of using a multidisciplinary approach to manage and prevent disability due to LBP.

Cerebral current-source distribution associated with pain improvement by non-invasive painless signaling therapy in patients with failed back surgery syndrome

  • Lee, Chang Han;Kim, Hyeong Seop;Kim, Young-Soo;Jung, Seokwon;Yoon, Chul Ho;Kwon, Oh-Young
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.437-446
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    • 2021
  • Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions: Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

Association between Prognosis of Low Back Pain Patients with Severity of Abnormal Lumbar Lordosis (한방병원에 입원한 요통 환자의 요추 전만각, 요천각 변화의 심각도에 따른 예후 분석 연구)

  • Han, Su-Bin;Kim, Eun-San;Kim, Hyo-Jun;Jo, Hoo-In;Kim, Mi-hye;Lee, Nam-Woo;Han, Jeong-Hun;Park, Byung-Hak;Son, Jae-Min;Kang, Do-Hyeon;Min, Tae-Woon;Lee, Hyun-Jun;Ahn, Jae-Seo;Lee, Han-Sol
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.143-154
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    • 2020
  • Objectives To analyze the prognosis of patients with low back pain according to the severity of abnormal lumbar lordotic angle and Ferguson's angle. Methods Data from electronic medical record of a total of 199 patients hospitalized in Korean medicine hospital were analyzed. With the sagittal view of lumbar spine X-ray, lumbar lordotic angle was defined as the angle between the superior endplate of L1 with the inferior endplate of L5. Ferguson's angle was defined as the angle between the superior surfaces of the sacral with a horizontal line. 'Measure Cobb's Angle Tool' of 'INFINITT PACS' was used to measure both angles. Lumbar lordotic angle and Ferguson's angle were subdivided into five sections. The number of days from onset and the duration of hospitalization were analyzed in each section. Results Severe hypolordotic lumbar lordotic angle group were found to have longer medical history and hospitalization duration than the control group. The ratio of long-term hospitalization (over 15 days) and chronic medical history (over 180 days) of patients with severe hypolordotic Ferguson's angle were significantly higher than the control group. The ratio of patients with chronic medical history (over 180 days) was significantly higher in severe hyperlordotic Ferguson's angle group than the control group. Conclusions Severe hypolordotic lumbar lordotic angle was related to patient's prognosis. Both severe hyperlordotic and severe hypolordotic Ferguson's angle were found to be related to patient's prognosis. However, a moderate loss of lumbar lordotic angle and Ferguson's angle was not related to prognosis of low back pain patients.

A Bibliographical study on Lumbago in Oriental Internal Medicine (내과(內科) 영역(領域)의 요통(腰痛)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Yoon, Cheol-Ho;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.15 no.2
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    • pp.318-346
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    • 1994
  • A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

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Relationship between Breathing Pattern Disorder and Joint Position Sense in Patients with Chronic Low Back Pain (만성요통환자의 호흡패턴이상과 관절위치감각의 관계)

  • Cho, Byungyun;Yoon, Junggyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.2
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    • pp.1-10
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    • 2019
  • Purpose : To investigate the relationship between breathing pattern disorder and joint position error (JPE) in patients with chronic low back pain (CLBP). Methods : Thirty nine patients with CLBP participated. End-tidal $CO_2$ and respiration rate (RR) were measured using a capnography. Breathing-hold time (BHT) and Nijmegen Questionnaire (NQ) were investigated. Thoracic excursion was measured with a cloth tape measurement technique. Joint position error were measured using a small laser point mounted on a lightweight headband. they were asked to relocate the head, after the neck movement on the horizontal plane. Pearson 's test was used for correlation analysis between respiratory variables and JPE in patients with CLBP. Independent t-test was used to verify the difference between thoracic and diaphragm breathing pattern in patients with CLBP. The significance level was set at 0.05. Results : There was a significant correlation between JPE (LR) and JPE (RR, EX) (r=.639, r=.813) (p<.001) and a low negative correlation with end-tidal $CO_2$ (r=-.357) (p<.05). There was a significant correlation between RR and JPE (EX) (r=.750) (p<.001). There was a low correlation between JPE (EX) and NQ (r=.333) (p<.05). There was a somewhat high negative correlation between NQ and thoracic excursion (r=-.528) (p<.001). There was a somewhat high negative correlation between thoracic excursion and JPE (LR, RR, EX) (r=-.470, r=-.484, r=-.602) (p<.001). There were no significant differences in the RR, BHT, NQ, and thoracic excursion between the thoracic and diaphragmatic breathing (p>.05). There was a significant difference in the JPE (EX), end - tidal $CO_2$, and VAS values between the thoracic and diaphragm breathing (p<.05). Conclusion : There was a correlation between JPE (EX) and NQ in patients with CLBP, and correlation between thoracic excursion and JPE (LR, RR, EX) and NQ. There was a significant difference in the JPE (EX), end-tidal $CO_2$ level, and VAS value in the comparison of thoracic breathing and diaphragm breathing. The results showed that breathing patterns and JPE were related to each other.

Coping Patterns in Chronic Low Back Pain : Relationship with Locus of Control and Self-Efficacy (만성 요통 환자의 대처 유형과 건강 통제위, 자기효능감과의 관계)

  • Kim, In-Ja;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.1-16
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    • 1995
  • Coping patterns were investigated in a sample of 126 patients with chronic low back pain by means of self-reported questionnaire. Based on the previous researches, coping pat terns were divided into the active cognitive coping, the active behavioral coping, the passive cognitive coping, and the passive behavioral coping. While all the above coping patterns were used, the passive behavioral coping was found to be used most frequently. Six subgroups were identified by cluster analytic procedure using their scores of the coping scale : active cognitive coper, general active coper, passive behavioral coper, general passive coper, multidimensional coper, and multi dimensional non-coper. Six subgroups were compared regarding locus of control, self-efficacy, pain and demographic variables. Distinct differences appeared among subgroups in internal locus of control, self-efficacy, and pain. General active coper and active cognitive coper had higher internal locus of control, higher self-efficacy, and lower pain. General passive coper and multidimensional non-coper had lower internal locus of control, lower self-efficacy, and higher pain. Passive behavioral coper had higher internal locus of control, lower self-efficacy, and higher pain. It supports the concept of learned helplessness due to prior experiences. Multi dimensional coper had higher internal, higher powerful others, and higher self-efficacy. So it corresponds to 'believer in control' group Identified by Wallston et at(1982). Unexpectedly this group also complained more pain. It could be interpreted in two ways. The more coping methods they use, the more they complain pain ; which is the result of Folkman et al (1986). Or they might be typical 'yea sayers'. These unique groups-passive behavioral coper and multidimensional coper-identified by this study supports the suggestion of Wallston et al(1982), about locus of control : individual's pattern of responses across the three scales may be more predictive than his or her scores on each of the scale seperately. The fact that passive coping was used more than active coping also suggests that self controlled active co ping is encouraged to chronic patients as well as acute patients. And it is necessary to articulate the coping scale and self-efficacy scale. It is also necessary to study the relationship of coping and adjustment by experimental design.

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