• 제목/요약/키워드: Chronic lower pain

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Pregnancy in Woman with Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report and Review of the Literature

  • Yoo, Hyung-Seok;Nahm, Francis Sahngun;Yim, Kyoung-Hoon;Moon, Jee-Youn;Kim, Yung-Suk;Lee, Pyung-Bok
    • The Korean Journal of Pain
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    • 제23권4호
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    • pp.266-269
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    • 2010
  • Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity, During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.

근전도 power spectrum을 이용한 만성근육동통 환자에 있어서의 저작근 피로에 관한 연구 (EMG Power Spectral Analysis on Masticatory Muscle Fatigue in Chronic Muscle Pain Patients)

  • 이채훈;김영구;임형순
    • Journal of Oral Medicine and Pain
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    • 제22권1호
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    • pp.145-155
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    • 1997
  • The purpose of this study was to compare differences in endurance time and EMG power spectral characteristics of the masticatory muscles during sustained isometric contraction between patients and controls. 15 CMD patients{8 women and 7 men, aged 15 to 38 years(24.1$\pm$7.5)}, and 15 healthy volunteers{8 women and 7 men, aged 15 to 30 years(24.7$\pm$3.4)} without past history or present symptoms of CMD were included in this study. Sustained isometric contractions of masticatory muscles were perfomeed as long as possible at 50% level of maximum voluntary contraction(MVC) of EMG activity via visual feedback, and the duration of sustained isometric contraction(endurance time) was examined. The author perfomed EMG power spectral analysis in the myoelectric signals of masseter and anterior temporal muscle during sustained isometric contraction in CMD patients with chronic muscle pain and healthy controls. The author came to following conclusions from the results. 1. The endurance time of the patient group was shorter than the control group in sustained isometric contraction of masticatory muscles(p<0.01). 2. MF values of masticatory muscles with sustained isometric contraction during endurance time were decreased following regression line in both groups(p<0.01, r>0.9). 3. The amount of MF shift to lower frequency range exhibited no significant differences between the patients and the control group in sustained isometric contraction during endurance time. 4. SMF to lower frequency range of the patient group was steeper than the control group in sustained isometric contraction during endurance time(p<0.05).

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요통 치료 도중 발견된 경막외강 녹색종을 동반한 백혈병 환자 경험 -증례 보고- (Clinical Experience of Leukemia with Extradural Chloroma during Treatment of Lower Back Pain -A case report-)

  • 임경준;오경희;문현석
    • The Korean Journal of Pain
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    • 제13권1호
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    • pp.119-122
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    • 2000
  • Granulocytic sarcoma (chloroma) is a rare, solid tumor of myelogenous stem cells, shows usually in patients with acute myelogenous leukemia and less commonly in patients with chronic myelogenous leukemia or myeloproliferative disorders. We report here a patient presenting acute paraparesis due to spinal epidural granulocytic sarcoma causing spinal cord compression in acute myelogenous leukemia with a brief review of literature.

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Effects of Sling and Resistance Rotation Exercises on Pelvic Rotation and Pain in Patients with Chronic Low Back Pain

  • Kim, Dae Hyun;Kim, Tea Ho
    • The Journal of Korean Physical Therapy
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    • 제30권5호
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    • pp.166-172
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    • 2018
  • Purpose: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). Methods: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. Results: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p<0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p<0.05). The pelvic rotation angle was significantly lower in the SG (p<0.05). The pain press threshold increased significantly in both groups (p<0.05). The visual analogue scale decreased significantly in the SG (p<0.05). Conclusion: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.

Factors associated with paravertebral muscle cross-sectional area in patients with chronic low back pain

  • Cankurtaran, Damla;Yigman, Zeynep Aykin;Umay, Ebru
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.454-462
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    • 2021
  • Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

근전도 스펙트럼 분석을 이용한 만성 요통 환자의 요부근육과 복부근육의 피로도 분석 (A Study of Muscle Fatigue in Lumbar and Abdominal Muscles in Patients with Chronic Low Back Pain by Electromyographic Power Spectral Analysis)

  • 남기석;이영희;이충휘;조상현
    • 한국전문물리치료학회지
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    • 제6권2호
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    • pp.16-31
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    • 1999
  • The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.

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요부운동 프로그램이 경막외 신경차단술을 받은 만성요통 환자의 통증, 일상생활제한 및 우울 감소에 미치는 효과 (The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections)

  • 김경아;이명하;김현경;정석희
    • 성인간호학회지
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    • 제25권4호
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    • pp.454-463
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    • 2013
  • Purpose: This study aimed to evaluate the effects of exercise program on chronic low back pain, daily living disability and depression in chronic low back pain patients treated with epidural injections. Methods: The design of this study was a nonequivalent control group pretest-posttest experiment. The sample was recruited among low back pain patients treated with epidural injections from an orthopedic specialty hospital. Participants were randomly assigned to a treatment group (n=25) or a comparison group (n=27). The treatment was a six week exercise program for low back pain. Data were collected from September to November 2011, and were analyzed using descriptive statistics, $x^2$-test, one-tailed t-test for independent samples, and Mann-Whitney U test using the SPSS/WIN 12.0 program. Results: Patients in the treatment group reported statistically significantly lower levels of back pain on flexion and extension, less daily living disability, and less depression than those in the comparison group. Conclusion: The back pain relief exercise program could be an effective adjunct nursing intervention for low back pain patients treated with epidural injections.

Can Knee Joint Flexion Position of the Raised Lower Limb Affect Trunk Muscle Activation During Bird Dog Exercise in Subjects With Chronic Low Back Pain?

  • Kim, Kyung-ho;Lee, Chi-hun;Baik, Seung-min;Cynn, Heon-seock
    • 한국전문물리치료학회지
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    • 제29권1호
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    • pp.79-86
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    • 2022
  • Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP.

만성요통환자의 복횡근 수축훈련을 위한 ADIM 적용사례 (Case Study of Application on ADIM of Patient With Chronic Low Back Pain for Contraction Training of Transversus Abdominis)

  • 김한일
    • 대한정형도수물리치료학회지
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    • 제17권2호
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    • pp.49-55
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    • 2011
  • Background: The purpose of this study was to identify the effects of the abdominal drawing-in maneuver (ADIM) for contraction training of transversus abdominis (TrA) to the patient with chronic low back pain (CLBP). Methods: A 37-year female patient with CLBP participated in study. This study was fix to method of ADIM that maintain to draw in lower abdomen in sitting position on chair and fix 1 time protocol that perform rest for 1-min and ADIM for 1-min during 10-min. Hereunder the subject performed 2 times protocol during 30-min. Measurement method were visual analogue scale (VAS), Korean version of Oswestry disability index (KODI) and using ultrasound imaging. Results: VAS was decreased 5cm to 1cm after intervention 3 weeks, KODI was decreased 22% to 9% after intervention 3 weeks and changes in thickness of the TrA were increased 32% to 68% during ADIM. Conclusions: These findings suggest that performed the ADIM took effect for decreased pain and functional disability level with increased changes in thickness of the TrA. Therefore, patients with CLBP should be use for training of deep abdominal muscles apply to the ADIM.

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만성 발바닥 근막염 환자에 대한 물리치료적 접근법: 특이적 뻗침운동과 고부하 강화 운동의 효과 비교 (Physiotherapy Approach to Patients with Chronic Plantar Fasciitis : Comparison of the Effects of Specific Stretching Exercise and High-Load Strengthening Exercise)

  • 추연기;배원식
    • 대한통합의학회지
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    • 제9권1호
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    • pp.151-161
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    • 2021
  • Purpose : This study was to investigate the effectiveness of ESWT and plantar fascia-specific stretching exercise vs ESWT and high-load strengthening exercise in patients with chronic plantar fasciitis. Methods : The subjects were randomized to extracorporeal shock wave therapy ( ESWT, for 3 weeks) and daily plantar-specific stretching (Group I: Stretch group) or ESWT and high-load progressive strength (Group II: Strength group) performed every second day. The main outcome measures were ultrasound, visual analogue scale (VAS), and Korean Foot Function Index (KFFI). The ultrasound (plantar fascia thickness), pain intensity I, II (the most painful of the day?, the pain when you first step in the morning?) and KFFI (functional performance) were compared between the groups. Results : No significant difference was observed between the groups in the plantar fascia thickness but pain intensity I, II was significantly lower in Group 2 than in Group 1 at only 12weeks and functional performance was also significantly increased in Group 2 compared to Group 1 at only 12 weeks. Conclusion : The high-load strengthening exercise consisting of the progressive exercise protocol, resulted in superior after 12 weeks compared with plantar-specific stretching. High-load strength exercise may aid in a quicker reduction in pain and improvements in functional performance.