• Title/Summary/Keyword: Chronic low-back pain patient

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A Retrospective Study: Influence of Beck Depression Inventory Score to a Patient under the Early Stages of Oriental Medical Treatment for Low Back Pain (Beck 우울 척도 점수가 요통 환자의 한방 치료 초기에 미치는 영향에 대한 후향적 연구)

  • Hong, Nam-Jung;Lee, Je-Kyun;Lee, Tae-Gyu;Park, Jong-Hoon
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.41-50
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    • 2011
  • Objectives : The purpose of this study is to know that Beck Depression Inventory(BDI) score to effect on improvement degree of low back pain after oriental medical treatment. Methods : We analyzed charts of 33 inpatients who were treated in Ja-Seng Hospital of Oriental Medicine and Bu-Cheon Ja-seng Hospital of Oriental Medicine. Subject is divided into Group A(BDI<10) and Group B(BDI${\geqq}$10). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were checked on admission, after 1 week, NRS and ODI were rechecked to estimate the efficacy of treatments. Results : 1. In both groups, NRS was significantly decreased(p<0.05). Analyzed result of the interaction between the two groups didn't show significant difference(p=0.197). 2. In Group A, ODI was significantly decresed(p<0.05). In Group B, ODI wasn't significantly decreased(p=0.058). The interaction analysis between the two groups didn't show significant difference(p=0.173). 3. Analyzing patients with chronic back pain longer than 6 months by the presence of depression tendency and NRS, ODI decrease after 1 week of ambulation, while the NRS reduction showed relevancy by the depression tendency (p<0.05), the ODI reduction didn't(p=0.272). Conclusions : 1. Although improvement of pain before and after the treatment and degree of functional recovery in high-level BDI group was less than low-level BDI group, but it was stastically insignificant. 2. High BDI score of patients with chronic low back pain is the factor of disturbing pain improvement.

Comparison of Lumbar Stabilization Exercises and Gluteal Strengthening Exercises on Pain, Disability and Psychosocial Factors in Low Back Pain Patients with Lumbar Instability (요추부 불안정성을 가진 요통환자의 요추부 안정화 운동과 둔근 강화 운동이 통증, 기능장애 및 심리사회수준에 미치는 효과 비교연구)

  • Jeon, Ji-hye;Kim, Suhn-yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.33-44
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    • 2017
  • Background: Lumbar stabilization exercise and gluteal muscle strengthening exercises are widely used to treat for lower back pain patient. The present study aimed to compare the effects of lumbar stabilization exercise and gluteal muscle strengthening exercises on chronic lower back pain with lumbar spine instability, with regard to pain intensity, disability, and psychosocial factors. Methods: Among 53 patients with chronic lower back pain, those with spine instability were selected using 5 examination tests. The selected 28 patients were randomly assigned to lumbar stabilization exercise group (LSE, n=15) and gluteal strengthening exercise group (GSE, n=13). Each group performed the corresponding exercise for 40 minutes, twice a week for 4 weeks. To analyze and compare the effects, pain intensity, the level of low back disability, and psychosocial factors were assessed before and after intervention. Results: There was significant difference in lower back pain intensity between the two groups before and after intervention. The change in low back disability was significant in the GSE group alone following intervention (p<.05), but no other significant difference was found between the groups. Among psychosocial factors, the changes in the fear-avoidance beliefs questionnaire (FABQ)-physical activity and FABQ-total were significant in the LSE group alone following intervention (p<.05). However, no significant difference were found in these factors between the two groups before and after intervention. Conclusions: LSE and GSE for lower back pain with lumbar spine instability showed no significant difference for pain intensity, physical disability, or psychosocial functioning.

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The Effects of the Needle Electrode Electrical Stimulation in the Auricular Therapy on the smokers and non-smokers with Low Back Pain (외이에 적용한 침전극저주파치료가 흡연 및 비흡연 요통 환자에게 미치는 효과)

  • Min, Kyung-Ok;Kim, Soon-Hee;Park, Su-Jin
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.45-52
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    • 2002
  • This study was intended to observe the relationship of pain alleviation between the group with needle electrode electrical stimulation applied on bach of head, lung, nasalis internae, shen-men, pharynx & larynx, and internal secretion which are the pants to regulate smoking and that, with no treatment of the kind among smokers and con-smokers with chronic low back pain. It also aimed to conduct a research of applying different treatment methods according to smoking, thus ultimately providing basic data needed by clinic therapists and to help achieve appropriate treatment effects considering the characteristics of each patient. The subject criteria were men who were in their 40's or 50's, smoking or non-smoking and came to the physical therapy of the hospital to cure the chronic low back pain which had lasted more than three months. The total 24 subjects were randomly divided into four groups according to smoking; the group of smokers with needle electrode electrical stimulation applied, that of smokers with no application of such treatment, that of non-smokers with the action of such treatment, and that of non-smokers with no application of such treatment Each group was measured in terms of four pain assessment methods of visual analogue scale(VAS), verbal rating scale(VRS), McGil pain questionnaire(MPQ), endorphin. And the results were as follows: 1. In terms of the effects of the needle electrode electrical stimulation in the auricular therapy on pain had by the smokers with low back pain, there was a statistical significance in VAS, VRS, and endorphin 1 between before and after the treatment. 2. In terms of the pain effects had by the smokers with low back pain when no needle electrode electrical stimulation in the auricular therapy was applied, there was a statistical significance in VRS and MPQ between before and after the treatment. 3. In terms of the effects of the needle electrode electrical stimulation in the auricular therapy on pain had by the non-smokers with low back pain, there was a statistical significance in VAS, VRS, and MPQ between before and after the treatment. In terms of the pain effects had by the non-smokers with low back pain when no needle electrode electrical stimulation in the auricular was applied, there was a statistical significance in VAS, VRS, and MPQ between before and after the treatment. 5. The smokers with low back pain were given the needle electrode electrical stimulation in the auricular therapy to see how it affected their pain. There was found pain reduction in number, but no statistical significance. 6. The subject suffering from low back pain were given the needle electrode electrical stimulation to see how it affected their pain according to smoking. There was found pain reduction in number, but no statistical significance. Based upon the results, it can be concluded that smokers with low back pain received the more effects of pain alleviation from the application of the needle electrode electrical stimulation in the auricular therapy compared to the rest of the groups who suffered from low back pain.

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The Study on History Period and Treatment Outcomes of Patients Admitted to a Korean Medicine Hospital for Low Back Pain (요통으로 한방병원에 입원한 환자의 병력기간별 호전도에 관한 연구)

  • Cho, Changyoung;Kim, Wonwoo;Seong, Ikhyun;Lee, Kapsoo;Jung, Jaehoon;Park, Sangwon;Lee, Jinho;Ha, Inhyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.137-143
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    • 2014
  • Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.

Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

The Isoinertial Assessment of Lumbar Function in Patients with Chronic Low Back Pain (등저항성삼축동력계(Isostation B-200)를 이용한 만성 요통 환자들의 요추부 기능)

  • Bae, Sung-Il
    • Journal of Korean Physical Therapy Science
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    • v.11 no.1
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    • pp.14-19
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    • 2004
  • Objective : This study obtained normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in patients with chronic low back pain. Subjects and Methods : 30 patients(male 15, female 15) with chronic low back pain in this study. Variable parameters that were measured with the Isostation B-200 were lumbar range of motion, isometric maximum torques, and maximum velocities in three axis. Results : In patient male group mean R.O.M. was $82.9{\pm}12.5$ degrees in lumbar rotation, $76.5{\pm}17.1$ degrees in lumbar flexion/extension, and $64.3{\pm}14.5$ degrees in lumbar lateral flexion. In patient female group mean R.O.M. was $78.4{\pm}18.5$ degrees in lumbar rotation, $71.7{\pm}20.4$ degrees in lumbar flexion/extension, and $63.2{\pm}14.4$ degrees in lumbar lateral flexion. In patient male group mean isometric maximum torques was $64.7{\pm}23.8ft-lbs$ in lumbar rotation, $81.1{\pm}42.0ft-lbs$ in lumbar flexion, $122.2{\pm}43.6ft-lbs$ in lumbar extension, and $101.0{\pm}37.0ft-lbs$ in lumbar lateral flexion. In patient female group mean isometric maximum torques was $41.9{\pm}9.2ft-lbs$ in lumbar rotation, $49.9{\pm}23.9ft-lbs$ in lumbar flexion, $90.1{\pm}26.8ft-lbs$ in lumbar extension, and $62.0{\pm}16.7ft-lbs$ in lumbar lateral flexion. In patient male group mean maximum velocity of isoinertial exercise with low (25%) resistance was $102.4{\pm}28.8deg/sec$ in lumbar rotation, $108.9{\pm}32.2deg/sec$ in lumbar flexion/extension, and $103.5{\pm}30.4deg/sec$ in lumbar lateral flexion. In patient female group mean maximum velocity of isoinertial exercise with low (25%) resistance was $84.1{\pm}24.4deg/sec$ in lumbar rotation, $93.2{\pm}32.9deg/sec$ in lumbar flexion/extension, and $98.5{\pm}33.7deg/sec$ in lumbar lateral flexion. In patient male group mean maximum velocity of isoinertial exercise with high (50%) resistance was $74.0{\pm}20.9deg/sec$ in lumbar rotation, $98.7{\pm}32.8deg/sec$ in lumbar flexion/extension, and $85.0{\pm}25.8deg/sec$ in lumbar lateral flexion. In patient female group mean maximum velocity of isoinertial exercise with high (50%) resistance was $67.3{\pm}26.4deg/sec$ in lumbar rotation, $82.5{\pm}31.0deg/sec$ in lumbar flexion/extension, and $79.7{\pm}23.9deg/sec$ in lumbar lateral flexion. Conclusion : Maximum isoinertial velocities were more reliable and more significant than isometric maximum torque for the objective assessment of chronic low hack pain.

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The Relationship between Perceived Stress and Coping Strategies in Patients with Chronic Low Back Pain (만성요통 환자들에서 스트레스지각과 대응전략 간의 관계)

  • Shin, Yoon-Sik;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2002
  • Objectives : The object of this study was to investigate the relationship between coping strategies and perceived stress or pain discomfort in patients with chronic low back pain. 80 patients with chronic low back pain and 100 normal controls participated in this study. Methods: Global assessment of recent stress (GARS) scale and Stress Response Inventory (SRI) were used to measure perception for stressors and stress responses. Coping scale and pain discomfort scale were used to measure coping strategies and pain perception. Results : Scores of perceived stress related to work or job, interpersonal relationship, changes in relationship, sickness or illness and the total scores on the GARS scale were significantly higher in those with chronic low back pain than normal controls. Scores of the SRI fatigue subscale scored significantly higher in those with chronic low back pain than normal controls. No significant difference was found on total scores of the pain discomfort scale between those with chronic low back pain and normal controls. The patients with chronic low back pain scored significantly higher on planful problem solving and positive reappraisal than normal controls. In the patient group, pain perception had significant positive correlations with total scores of the SRI and scores of stress perception related to illness or injury. The extent of escape-avoidance showed significant negative correlations with age, whereas the extent of distancing or escape-avoidance had significant negative correlations with the level of education. Significant difference was also found in accepting responsibilities between male subjects and females. However, no significant correlations were found between coping strategies and perceived stressors, stress responses or pain perception. Conclusion : The results suggest that patients with chronic low back pain were more likely to use more active coping strategies than normal controls, though the former had more perception for stressors than the latter. It was also found that coping strategies used by the patients were associated with sociodemographic factors, but that they were not associated with perceived stressors, stress responses or pain perception.

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Reliability of the Modified - Modified $Sch{\ddot{o}}ber$ Methods for Measuring Lumbar Flexion and Extension ROM (요부굴곡과 신전관절범위측정을 위한 MMS방법 신뢰도)

  • Kim, Tae-Suk;Cho, Jung-Sun;Park, Young-Han
    • Journal of Korean Physical Therapy Science
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    • v.2 no.4
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    • pp.763-770
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    • 1995
  • The primary purpose of this study was to determine the reliability of lumbar flexion and extension range-of -motion measurements obtained with the modified -modified $Sch{\ddot{o}}ber$ methods on normal and subjects with low back pain. Sixty two, aged 20 to 30 years(x = 22.0, SD = 2.07), with normal and twenty two, aged 14 to 66 years(x = 35.6, SD = 15.88) with chronic low back pain were measured by two physical therapist with 3 to 10 years (x = 6.5) of clinical experience. The therapist used the modified-modified $Sch{\ddot{o}}ber$(MMS) techniques to measure, in random order and on two occasions, the subjects' lumbar flexion and extension. For therapist 1, Intraclass correlation coefficients(ICC) for test-retest reliability for normal varied .9923, .8802(flexion, extension). and low back pain pateint varied .9950, .9313(flexion, extension). For therapist 2. ICC. for test-retest reliability for normal varied .9903, .8921(flexion, extension). and low back pain pateint varied .9843, .9551(flexion, extension). Interrater reliability for normal varied .9477, .6960(flexion, extension) and low back pain pateint varied. 9776, .7576(flexion, extension). Thus the MMS. method appears to be a reliable method for normal and patient with low back pain.

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Cost-Benefit Analysis of Back School Program for Occupational Low Back Pain Patients (직업성 요통환자에서 재활 프로그램(Back School Program) 도입의 비용-편익분석)

  • Ju, Yeong-Su;Ha, Mi-Na;Han, Sang-Hwan;Kwon, Ho-Jang;Cho, Soo-Hun;Kim, Chang-Yup;Kim, Sun-Min
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.347-357
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    • 1996
  • Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

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Effects of Electrical Stimulation on Patients with Non-Specific Low Back Pain : A Meta-Analysis of Domestic Database (비특이적 만성 허리통증 환자에 대한 전기자극의 효과 : 국내 데이터베이스의 메타분석)

  • Lee, Jeong-Woo;Cho, Sung-Hyoun
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.37-52
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    • 2022
  • Purpose : The purpose of this meta-analysis was to evaluate the effects of electrical stimulation on patients with non-specific low back pain. Methods : Domestic databases were gathered from studies that conducted clinical trials associated with electrical stimulation and its impact on pain of non-specific low back patients. A total of 681 studies were identified, with 12 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, outcome, and study design (PICO-SD). The search outcomes were items associated with low back pain. Cochrane risk of bias 2 (RoB 2) was used to evaluate the quality of 12 randomized controlled trials. Effect sizes (Hedges's g) in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were conducted to analyze the effect according to the sample size and the consistency of the effect size. Results : The following factors had a large overall effect size (Hedges's g=1.28, 95 % CI=.20~2.36) involving electrical stimulation on non-specific low back pain. The subgroup analysis all showed a statistical difference in the types of study design, electrical stimulation, and assessment tool. No statistically significant difference was found in the meta-regression analysis. Publican bias was found in the data. Conclusion : The findings in this study indicate that electrical stimulation interventions have a positive effect on patients with non-specific low back pain. However, due to the low quality of studies and publication bias, the results of our study should be interpreted cautiously.