• Title/Summary/Keyword: Leg pain

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Effect of Bong Chuna Manual Treatment Combined with Oriental Medical Treatment on Posterior Inferior Ilium Deviation ; 3 Cases Report (봉추나요법과 한방치료를 병행한 후하방장골 변위 교정 3예)

  • Oh, Won-Kyo;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.1
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    • pp.173-185
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    • 2008
  • Objectives : The purpose of this study was to observe the effect of Bong (a type of stick which is called bong) Chuna manual therapy (CMT) on the correction of posterior inferior (PI) ilium deviation, and evaluate changes of pain intensity and Oswestry Disability Index (ODI) for the treatment of low back pain. Methods : We measured leg length inequality (LLI), as an indicator of correction of PI ilium, before and after the Bong CMT twice immediately, and also checked the change of LLI in the course of 10 times of treatment. Ten times of Bong CMT with oriental medical treatment, such as acupuncture and bee venom pharmacopuncture, were performed not only to correct the PI ilium deviation but also to alleviate pain. Visual Analog Scale (VAS) and Oswetry Low-back Pain Disability Index (ODI) score were scored to evaluate the pain and function of low back. Results : In this study, LLI was decreased in general while we performed correction of PI ilium deviation immediately, also effectively decreased comparing between before and after 10 times of Bong CMT, Bong CMT with oriental medical treatment improved pain and function of low back. Conclusions : These results suggest that Bong CMT may be an effective method for the correction of PI ilium deviation. However more rigorous study should be followed because of small cases report.

Impact of Position on Efficacy of Caudal Epidural Injection for Low Back Pain and Radicular Leg Pain Due to Central Spinal Stenosis and Lumbar Disc Hernia

  • Altun, Idiris;Yuksel, Kasim Zafer
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.205-210
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    • 2017
  • Objective : This study was performed to evaluate and compare the efficacies of caudal epidural injections performed at prone and lateral decubitus positions. Methods : A total of 120 patients suffering from low back pain and radicular leg pain were included and patients were randomly distributed into 2 groups according to the position during injection. In Group 1 (n=60; 32 women, 28 men), caudal epidural injection was performed at prone position, whereas it was implemented at lateral decubitus position in Group 2 (n=60; 33 women, 27 men). Visual analogue scale, Oswestry Disability Index (ODI), walking tolerance (WT) and standing tolerance (ST) were compared in 2 groups before and after injection. Results : In Group 1, ODI values were higher at 30th minute (p=0.007), 3rd week (p=0.043) and 6th month (p=0.013). In Group 1, ODI, VAS and ST values were improved significantly at all follow-up periods compared to initial values. In Group 1, WT scores were better than initial values at 30th minute, 3rd week and 3rd month. In Group 2, ODI scores at 30th minute, 3rd week, 3rd month and 6th month were improved while VAS and ST scores were improved at all periods after injection. WT scores were better at 30th minute, 3rd week and 3rd month compared to initial WT scores. Conclusion : Our results indicated that application of injection procedure at lateral decubitus position allowing a more concentrated local distribution may provide better relief of pain.

Effects of Zingiberis Rhizoma Pharmacopuncture Injected at GB30 and ST36 on Neuropathic Pain in Rats (환도(GB30) 및 족삼리(ST36) 건강약침이 신경병증성 통증 유발 흰쥐에 미치는 영향)

  • Hwang, Min Sub
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.52-62
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    • 2019
  • Objectives : The objective of this study was to investigate the effects of Zingiberis Rhizoma Pharmacopuncture(ZP) at GB30 and ST36 in neuropathic pain induced SD rats by the block of Transient Receptor Potential Vanilloid 1(TRPV1). Methods : Neuropathic pain in rats was induced by tibial and common peroneal nerve transection of right leg. The rat subjects were divided into 6 groups : normal(Nor, n=5), control(Con, n=5), neuropathic pain plus 2 mg/kg ZP injection at GB30 and ST36(ZP-A, n=5), 10 mg/kg ZP(ZP-B, n=5), 20 mg/kg ZP(ZP-C, n=5) and 0.45 mg/kg Tramadol(Tra, n=5). Three days after the surgery, injections were administered once a day for 17 days. Withdrawal response of neuropathic rats' legs were measured by stimulating the paw of Right leg with von frey filament, acetone and radient heat on day 3, 7, 11, 15, 19 after surgery. After all treatments were completed, c-Fos in the midbrain central gray and TRPV1 & TRPA1 of DRG(L5) were analyzed. Results : Groups ZP-B and ZP-C showed a meaningful decrease in the withdrawal response of mechanical allodynia, thermal hyperalgesia and cold allodynia compared to the control group(p<0.05, p<0.01, p<0.001). Groups ZP-B and ZP-C showed a meaningful decrease in the expression of c-fos and TRPV1 protein level compared to the control group(p<0.05, p<0.01, p<0.001). Conclusions : These results suggest that Zingiberis Rhizoma Pharmacopuncture at GB30 and ST36 could decrease mechanical & cold allodynia and thermal hyperalgesia by block the TRPV1 on the model of neuropathic pain.

Immediate Effect of Flexion-Distraction Spinal Manipulation on Intervertebral Height, Pain, and Spine Mobility in Patients with Lumbar Degenerative Disc Disease

  • Pi, Taejin;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.235-243
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    • 2021
  • Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation for Elderly Isthmic Spondylolisthesis

  • Lee, Dong-Yeob;Lee, Sang-Ho;Maeng, Dae-Hyeon;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.175-179
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    • 2006
  • Objective : The surgical outcome of anterior lumbar interbody fusion[ALlF] with pedicle screw fixation for elderly isthmic spondylolisthesis was analyzed. Methods : Consecutive nineteen elderly patients [aged 65 years or more] with isthmic spondylolisthesis [Grade I or II] who underwent single level ALIF with pedicle screw fixation in 2002 were analyzed. Using clinical chart and mailed questionnaires, preoperative and postoperative Visual Analogue Scale[VAS] of back and leg pain and postopertive Macnab criteria were evaluated. Results : The mean age at the time of operation was 68.4 years [range 65 to 78 years]. Twelve patients underwent ALIF with percutaneous pedicle screw fixation. Seven patients underwent ALIF followed by posterior decompression and pedicle screw fixation. The postoperative complication rate was 10.5% [wound dehiscence in 1 patient and incisional hernia in 1 patient]. There was no postoperative major morbidity or mortality. At a mean follow-up duration of 30.7 months [range 25 to 35 months], 93.3% [14/15] of the patients showed excellent or good outcomes in terms of Macnab criteria. The mean VAS scores of back pain and leg pain significantly decreased after surgery. Conclusion : ALIF with pedicle screw fixation yielded favorable results for elderly isthmic spondylolisthesis in selected cases.

Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

  • Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Kim, Jong-Gue
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.192-195
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    • 2009
  • We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

The Effect of Korean Medicine with Needle-embedding Therapy on a Lumbar Herniated Intervertebral Disc : A Case Report (요추 추간판 탈출증 환자에 대한 매선을 포함한 한의 복합치료의 효과 : 증례보고)

  • Hong, Seung Pyo;Bae, Ji Min;Kim, Dae Hun;Yang, Gi Young;Lee, Byung Ryul
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.219-224
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    • 2016
  • Objectives : The purpose of this study was to report the clinical effects of needle-embedding acupuncture therapy combined with Korean medicine on a lumbar herniated intervertebral disc. Methods : We treated one patient with a lumbar herniated intervertebral disc with needle-embedding acupuncture therapy combined with Korean medical treatment. We checked the numeric rating scale(NRS), oswestry low back pain disability index(ODI) and straight leg raising test(SLRT). Results : In this case, the numeric rating scale decreased, while the straight leg raising test results improved. Conclusion : Needle-embedding acupuncture therapy could be effective for pain-reduction for a lumbar herniated intervertebral disc.

Effects of Muscle Strengthening Exercise Program on Pain, Fatigue, Physical Function in Elderly Women with Total Knee Arthroplasty (근력강화 운동프로그램이 슬관절 전치환술 여성 노인환자의 통증, 피로, 신체적 기능에 미치는 영향)

  • Min, Hye-Sook;Jung, Yun-Hwa;Kim, Eun-Sook;Kim, Seon-Hwa;Choi, Young-Ji
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.203-214
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    • 2011
  • Purpose: The purpose of the study was to identify the effects for 4-weeks muscle strengthening exercise program on pain, fatigue, and physical function(muscle strength of leg, walking competence, balance, flexibility of patella) in elderly women with total knee arthroplasty(TKA). Method: Utilizing a quasi-experimental design, 30 TKA patients consisted of the experimental group (n=15) and control group (n=15). The experimental group participated in the muscle strengthening exercise program, twice a day for 4 weeks. Data were analyzed with SPSS WIN 18.0 program, using repeated measure ANOVA. Result: As time goes by, There were significant differences in muscle strength of leg (F=6.60, p<.001), walking competence(F=7.15, p<.001), and balance(F=17.55, p<.001) between the experimental and the control groups. Conclusion: The findings of this study revealed the positive effects of muscle strengthening exercise program in elderly women with TKA.

"Post-Decompressive Neuropathy": New-Onset Post-Laminectomy Lower Extremity Neuropathic Pain Different from the Preoperative Complaint

  • Boakye, Lorraine A.T.;Fourman, Mitchell S.;Spina, Nicholas T.;Laudermilch, Dann;Lee, Joon Y.
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1043-1052
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    • 2018
  • Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

Correlation Analysis between HIVD of L-spine MRI and Digital Infrared Thermal Image (DITI) on the Patients of LBP Who Visit Korean Medicine Hospital (한방병원에 요통, 하지방사통으로 내원한 환자 236명에서 MRI상 추간판 탈출증과 적외선 체열 검사(DITI)와의 연관성 분석)

  • Kim, Gil-Hwan;Kwon, Ok-Jun;Joo, Young-Kuk;Song, Seung-Bae;Kim, Doo-Ri;Choi, Young-Jun;Shin, Soo-Ji
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.107-115
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    • 2017
  • Objectives This study is planned to classify correlation between HIVD of L-spine MRI and Digital Infrared Thermal Image (DITI). Methods We measured the temperature of both leg whose 120 men and 116 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. And We use Magnetic Resonance Imaging (MRI) for classifying the patients who has lumbar intervertebral disc or not. Results 1) There was no statistical relation between difference of both leg's temperature and gender (p>0.05). 2) There was meaningful statistical relation between difference of both leg's temperature and age (p<0.05). 3) There was meaningful statistical relation between direction of HIVD of L-spine and direction of temperature reduction. 4) There was meaningful statistical relation between the severity of HIVD of L5/S1 and degree of temperature reduction. But there was no statistical relation between the severity of HIVD of L3/4, L4/5 and degree of temperature reduction. Conclusions We can use Digital Infrared thermal image (DITI) on low back pain patients for diagnosis. But we should not use DITI alone. DITI has limit in diagnosis.