• Title/Summary/Keyword: Chronic Low Back Pain

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A Survey on Functional Status among Low-Income Older Adults Living at Home (일개지역 저소득층 노인의 신체적 기능상태에 관한 연구)

  • 전경자;조윤미
    • Journal of Korean Academy of Nursing
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    • v.31 no.5
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    • pp.749-758
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    • 2001
  • The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease. Method: Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn. Results: 9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia. Conclusion: The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.

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A Clinical Survey of Patients of Pain Clinic (통증치료실 환자의 임상통계적 고찰)

  • Jang, Young-Ho;Lee, Jung-Koo;Cheun, Jae-Kyu;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.103-109
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    • 1995
  • The pain clinic in our institution opened on of June, 1984. since then until December 1994, we have had 1,741 patients who had been treated on an out-patient basis. The patients were analysed retrospectively according to their sex, age, and retrospective disease. There were 969 male(55.7%) and 772 female patients(44.3%) In the age distribution of the patients, the highest incidence was in the forties with 463 patients(26.6%). The second highest age incidence was in the thirties with 357 patients(20.5%), and the third highest age incidence was in the sixties with 341 patients(19.6%). In this figure, there were 203(26.6%) stomach cancer patients, 135(17.7%) cervix and uterine cencer patients, 81(10.6%) colorectal cancer patients, 74(9.7%) hepatoma patients, and 68 (8.9%) pancreatic cancer patients. The patients with non malignant chronic pain numbered 977(56.1%). In this figure, there were low back pain of 188(19.2%), sudden deafness of 17.5%, Buerger's disease of 63(6.5%) and postherpetic neuralgia of 56(5.7%).

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Ryodoraku Application for Diagnosis : a Review of Korean Literature (양도락의 진단적 활용에 대한 문헌 고찰 - 국내문헌을 중심으로 -)

  • Noh, Seung-Hee;Kim, Kun-Hyung;Yoon, Young-Jin;Yang, Gi-Young;Kim, Jae-Kyu;Lee, Byung-Ryul;Yim, Yun-Kyoung
    • Korean Journal of Acupuncture
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    • v.28 no.4
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    • pp.125-135
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    • 2011
  • Objectives : This study is aimed to evaluate the diagnostic value of Ryodoraku for traditional Korean medicine practice reported in the Korean literature. Methods : A search of seven Korean databases was performed up to May 2011 using the search term 'Ryodoraku(in Korean)'. All clinical studies on diagnostic Ryodoraku characteristics were included. Results : The search yielded 59 studies, of which 5 were considered suitable for this analysis. Four were observational studies. Only one was a controlled trial. Average Ryodoraku score(RS), mean values for each measure point, physiologic limit, number of Pyesaek and Gyeokcha, and pattern classification were used as references for the analysis. Correlations were observed between average RS and idiopathic Parkinson's disease, some sub-groups of respiratory disease, chronic low back pain, and menopause. Some mean values for measure points showed particularly high or low tendencies in patients with idiopathic Parkinson's disease, chronic low back pain, and menopause. Positive correlations were observed between the number of Pyesaek and H-Y stage in idiopathic Parkinson's disease and F2(肝) and the modified Kupperman's index with menopausal women. The four classes, organized based on Ryodoraku pattern, showed differences in various characteristics. Conclusions : Since only five studies met the experimental conditions, this evaluation of the diagnostic value of Ryodoraku in various situations is limited. Future studies should be conducted using various physiologic and pathologic situations.

A Comparison of the Efficacy of Epidural Steroid Injections in Terms of the Dosages and Frequency of Triancinolone Injections for the Pain Related to Lumbar Spinal Stenosis or Herniated Disks (요추 추간판 탈출증과 척주관 협착에 의한 통증 치료에 Triamcinolone 시술 횟수와 용량에 따른 경막외 스테로이드 주입법의 효과 비교)

  • Hwang, Byeong Moon;Hwang, Bum Sang
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.72-76
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    • 2006
  • Background: The objective of this study was to describe the extent of pain relief after an epidural steroid injection in the patients suffering from chronic low back pain from herniated disks or lumbar spinal stenosis. Methods: The study was prospectively designed for patients suffering with lumbar spinal stenosis (LSS) and herniated disks (HD) who were referred to a hospital-based pain clinic for epidural steroid injections (ESI). The pain was assessed with using a visual analog scale at baseline, two weeks after the first ESI and two weeks after the third ESI. Results: Eighty patients were enrolled, and all of them provided pain ratings before and after the injections. The LSS patients seemed to improve less than did the HD patients. The results showed no significant differences in the triamcinolone dosage and the frequency of injections for determining the efficacy of ESI. Conclusions: The LSS patients tended to have a less effective respond to ESIs than did the HD patients. The unsatisfactory response to ESI by the LSS patients underscores the need for randomized controlled trials of performing ESI in this population.

The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.346-368
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    • 2021
  • Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

The Effects of Lumbar Stabilizing Exercise on the Functional Recovery and the Range of Motion of Low Back Pain Patients (요부 안정화 운동이 요통환자의 기능회복과 가동범위에 미치는 영향)

  • Jung Yeon-Woo;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.157-182
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    • 2004
  • The purpose of this study was to evaluate effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients. The subjects were consisted of sixty patients who had non specific chronic low back pain(32 females. 28 males; mean aged 37.3) from 19 to 65 years of age(mean age : 37.3). All subjects randomly assigned to the lumbar stabilizing exercise group, the modalities treatment group, the manual treatment group. Lumbar stabilizing exercise group received manual treatment with lumbar stabilizing exercise for 30minutes, modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 20minutes and US or MWD used deep thermal therapy for 15minutes, manual treatment group received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. The results of this study were summarized as follows : 1. The MR-MDQ of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 2. The VAS of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 3. The RST of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 4. The F-T-FT of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 5. The results of analyzed effects of MR-MDQ, RST, F-T-FT were significantly reduced (p<.05), but VAS wasn't significantly reduced(p>.05) between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment. 6. The results of LSD post-hoc to find difference between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment that MR-MDQ was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and VAS wasn't significantly reduced all treatment group(p>.05), and RST was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and F-T-FT was significantly reduced stabilizing exercise group than modalities treatment group and manual treatment group (p<.05).

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The effect of needle tip position on the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbar radicular pain: a retrospective observational study

  • Kim, Won-Joong;Park, Hahck Soo;Park, Min Ki
    • The Korean Journal of Pain
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    • v.32 no.4
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    • pp.280-285
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    • 2019
  • Background: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. Methods: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. Results: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. Conclusions: The analgesic efficacy of PRF treatment did not differ with the needle tip position.

Caudal Steroid Injection for Treatment of Piriformis Syndrome (이상근 증후군의 치료를 위한 미추차단의 효과 - 증례보고 -)

  • Han, Young-Jin;Choe, Hyun-Gyu;Lee, Sun-Suk;Choe, Huhn
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.56-59
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    • 1991
  • Piriformis syndrome is a syndrome of low back and leg pain thought to be due to chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. We have utilized an alternative approach using cauaal steroid in local anesthetics injection in the treatment of piriformis syndrome. I it was a very effective method without any complications.

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Analysis of Patients with Cervical Epidural Steroid Injection and Nerve Block (경부 경막외 Steroid 주입 및 차단술을 받은 환자의 분석)

  • Chung, Sung-Won;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.98-101
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    • 1996
  • Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

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