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Intractable Pain Management by Combined Korean Medicine Treatment Including Acupotomy in Lumbar Disc Herniation: A Case Report (한방복합치료로 난치성 통증을 동반한 요추 추간판탈출증이 호전된 증례보고)

  • Choi, Hyeon Kyu;Lee, Young Rok;Cha, Hyun Ji;Sung, Ki Jung;Kim, Beom Seok;Kim, Min Ju;Lee, Ye Ji;Jeon, Ju Hyun;Kim, Young Il
    • Korean Journal of Acupuncture
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    • v.38 no.3
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    • pp.175-181
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    • 2021
  • A 57-year-old female diagnosed with L5-S1 lumbar intervertebral disc herniation, suffering from severe pain despite taking tapentadol received combined Korean medicine treatment, including acupotomy, acupuncture, pharmacopuncture, and herbal therapies for 53 days. To assess pain, Numeric Rating Scale (NRS) and lumbar range of motion (ROM) were checked daily from the day of admission. Moreover, the Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) were used to evaluate function and quality of life. After combined Korean medicine treatment, reabsorptioin of intervertebral disc was confirmed by radiological examination; pain reduced from NRS 5~7 to NRS 1~2; lumbar ROM in extention increased from 20° to 30°; and function and quality of life improved. The results suggest the possibility that a combined Korean medical treatment, including acupotomy, can be used as an alternative to opioids for pain management of lumbar vertebral disc herniation.

A Case Report inculding Pharmacopuncture Therapy at Lumbar Facet joints for a Patient with Lumbar Disc Herniation with Lower Back Pain and Leg Radiating Pain that Worsen during Pregnancy (요추 후관절 약침 치료를 병행한 임신 중 요통 및 하지방사통이 악화된 요추 추간판 탈출증 환자 증례 보고)

  • Kim, Su-Jin;Kim, Sun-A;Kim, Min-Kyung;Lee, Si-Won;Kyung, Da-Hyun;Bae, Ji-Eun;Kwon, Yong-Su;Huh, Hyo-Seung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.93-103
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    • 2021
  • Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.

Determinants of Korea's Trade before and after the 2008 Financial Crisis Activating Augmented Gravity Model (중력모형을 이용한 2008년 금융위기 전후 한국의 교역결정요인 분석)

  • Lee, Doowon;Kim, Donghee;Park, Seokwon
    • International Area Studies Review
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    • v.16 no.1
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    • pp.243-274
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    • 2012
  • This research analyzes the determinants of Korea's trade using the Gravity model, Chow test and panel data anaysis. According to the pooled panel OLS analysis using the gravity model and Chow-test, Korea's trade patterns before and after the 2008 financial crisis are heterogeneous. Variables of basic gravity model, GDP per capita, distance, and population, identically showed positive and significant correlation with trade volume before and after financial crisis, but also equally showed the decrease in absolute value of coefficient. On the other hands, Overseas Direct Investments(ODI) variable showed the increase in absolute value of coefficient. But TCI was no longer significant. This research is significant in that it is able to show the strategy for the long term growth in Korea's volume of international trade through econometric analysis based on data of 55 trading partner of Korea.

Association between body composition parameters and non-specific low back pain in sedentary workers

  • Kim, Wondeuk;Park, Dongchun;Shin, Doochul
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.64-68
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    • 2021
  • Objective: In clinical practice, there are a lot of exercise to reduce body weight or reduce the amount of body fat in order to solve back pain. However, many studies have contradicted the relationship between back pain and weight or body fat mass. The purpose of this study was to investigate the relationship between fat mass, body mass index and low back pain of office worker. Design: Crossed-sectional study Methods: Among the white-collar workers diagnosed with non-specific back pain by doctors, subjects who were not included in the exclusion criteria were selected to measure the subject's body fat mass, body mass index, pain intensity, and disability index due to back pain. The NPRS was used for the intensity of back pain of office workers, and the ODI was used for the degree of disability due to back pain. A body composition analyzer was used to measure the body fat mass and body mass index of white-collar workers. Results: There was no significant difference between the two groups in the comparison between the normal group and the excessive group according to the criteria of fat mass and body mass index. In the correlation analysis of fat mass, body mass index, pain intensity, and disability index, it was found that there was a significant correlation between fat mass and body mass index. However, neither fat mass nor body mass index had a significant correlation with pain intensity and disability index. Conclusions: The fat mass and body mass index of office worker do not affect low back pain.

The Effect of Non-face-to-Face Class due to COVID-19 on Academic Stress and Back Pain in University StudentsThe Effect of Non-face-to-Face Class due to COVID-19 on Academic Stress and Back Pain in University Students

  • Kim, Yoo Rim;Kim, Dong Hoon
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.43-48
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    • 2022
  • Objective: In the present study, to determine the extent of academic stress and pain from sitting for a long time, we will use a questionnaire to examine the effects of non-face-to-face stress and back pain on college students who have conducted non-face-to-face lectures. Design: Survey research Methods: A questionnaire was conducted using Naver foam to identify academic stress, attitude and time to listen to lectures, and the extent of back pain for college students who are experiencing non-face-to-face lectures. Outcome measures include the scale of academic stress (SAS), the Numeric rating scale (NRS), the Oswestry Disability Index (ODI Korea version) was implemented. The difference in academic stress was analyzed by t-test and one-way ANOVA, and the correlation between academic stress and back pain was analyzed using the Spearman correlation coefficient. In order to examine the academic stress, consistency, and stability, the reliability of the academic stress items was measured by examining the reliability with the Cron-Bach alpha coefficient. Allstatistical significance levels were α=0.05. Results: According to the general characteristics of the subject, there were no statistically significant results compared to gender (P<0.05), but the higher the grade, the higher the stress index, the higher the level of pain. Conclusions: This study confirmed that non-face-to-face lectures caused by COVID-19 have increased academic stress and the resulting increase in back pain in college students.

Chuna Manual Therapy for Postpartum Low Back Pain: Systematic Review (출산 후 요통에 대한 추나요법의 효과: 체계적 문헌고찰)

  • Cho, Ju-chan;Park, In-hwa;Hwang, Man-Suk;Heo, In
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.1-8
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    • 2021
  • Objectives This study aimed to evaluate the effect of chuna manual therapy (CMT) for postpartum low back pain using a systematic review. Methods We performed a literature search using 12 electronic databases up to the end of September 2021. We included randomized controlled trials (RCTs) that evaluated the effect of CMT in the treatment of postpartum low back pain. The risk of bias was evaluated using the Cochrane risk-of-bias tool. Results Four randomized controlled trials were reported statistically significant effect in pain VAS, ODI and JOA of chuna manual therapy compared with moxibution, electro acupuncture, hyperthermia or usual care. As a result of assessing the risk of bias tool, most of the contents of the evaluation items were not identified, so it was evaluated as an uncertain risk. Conclusions CMT may be effective in treating postpartum low back pain. However, evidence was limited due to the small sample size, lack of well-designed RCTs and regional bias. Further well-designed studies are required to obtain stronger evidence.

Clinical and Polysomnographic Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea (REM 수면 의존성 폐쇄성 수면무호흡증 환자의 임상적 특성과 수면 변인에 관한 연구)

  • Lee, Yu-Jin;Lee, Soon-Jeong;Kang, Dong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.77-81
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    • 2008
  • Introduction: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. Methods: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (5$53.7{\pm}16.7$ years, 42 males). REM-dependent OSA was defined as AHI-REM/AHI-NREM ratio>2. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. Results: Among 56 patients, 37.5% (n=21, average age of $52.3{\pm}19.7$ years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). Conclusion: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.

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Correlational Analysis of Supine Position Time and Sleep-related Variables in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡 증후군에서 앙와위 자세시간과 수면관련변인 간 상관관계 분석)

  • Kim, Si Young;Park, Doo-Heum;Yu, Jaehak;Ryu, Seung-Ho;Ha, Ji-Hyeon
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.32-37
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    • 2017
  • Objectives: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. Methods: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. Results: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. Conclusion: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.

A cephalometric study on the morphologic characteristics of Class II division 2 malocclusion of the Korean Female patients (한국인 여성 II급 2류 부정교합환자의 측모두부방사선 형태학적 특징)

  • Kim, Tae-Woo;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.28 no.5 s.70
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    • pp.855-864
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    • 1998
  • The purposes of this study were to evaluate the cephalometric characteristics of Korean female patients with Class II division 2 malocclusion and to compare Korean females with Caucasian females who had same type of malocclusion. All of the samples had Class II division 2 malocclusion with deep overbite (more than 4mm) and full permanent dentition. These samples were divided into two groups according to the races: Group 1(N=16; Korean females; average age=18Y 2M) and Group 2 (N:20; Caucasian females; average age=14Y 2M). The pretreatment lateral cephalograms were measured, analyzed and compared by using 38 variables and independent t-test. And the results were as follows: 1. Although there were no differences in Overbite, SN to mandibular plane angle, Palatomandibular plane angle, and FMA between Group 1 and 2, the other vertical relation variables of maxilla and mandible (SN to palatal plane angle, SN to occlusal plane angle, ODI) of Group 1 showed more clockwise rotation tendency of occlusal plane and less hypodivergency tendency than those of Group 2. 2. There were no differences in mandibular body length and ramus height between Group 1 and 2 except small upper genial angle of Group 1. There was less counterclockwise rotation tendency of mandible in Group 1. 3. There were no statistical significant differences in UAFH/LAFH and PFH/AFH between Group 1 and 2. 4. Although there were no differences of overjet and anteroposterior position of mandible between Group 1 and 2, the position of maxilla of Group 1 was more retropositioned than that of Group 2. 5. Except the more protrusion of lower incisor to A-Pog of Group 1, there were no differences of inclination and distance of upper and lower incisors to basal plane between Group 1 and 2. 6. The distance from upper- first molar to palatal plane showed no difference between Group 1 and 2. But the distance from lower first molar to mandibular plane of Group 1 was greater than that of Group 2. So it may be partially related to the clockwise rotation of occlusal plane and the less counterclockwise rotation tendency of mandible of Group 1. 7. Group 1 had more protrusive upper and lower lips than Group 2.

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The Study on Correlation between the Degree of Herniated Intervertebral Lumbar Disc at L4~5 Level and Improvement of Low Back Pain Treated by Korean Medicine Therapy (제 4~5번 요추 추간판 탈출 정도와 요통의 한의학적 치료 효과의 상관성 연구)

  • Yoo, Hyung-jin;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Lee, Gie-on;Lee, Dong-hyun;Kim, Sang-min
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.105-121
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    • 2016
  • Objectives The purpose of this study was to compare the effects between the degree of herniated intervertebral lumbar disc (HIVD) at L4-5 level and improvement of low back pain treated by Korean Medicine therapy. Methods 567 patients who received inpatient treatment from May 2014 to December 2015 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 6 groups by the degree of HIVD at L4-5 level confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, Normal stage on Intervertebral Lumbar Disc at L4-5 level group's Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) improvement was $1.30{\pm}1.62$, $4.52{\pm}11.82$ and $0.04{\pm}0.11$ respectively. Bulging group's improvement was $3.25{\pm}2.81$, $8.28{\pm}13.02$ and $0.09{\pm}0.17$ respectively. Spinal canal occupying ratio (SOR) less than 20 group's improvement was $2.15{\pm}1.92$, $11.79{\pm}17.81$ and $0.13{\pm}0.23$ respectively. SOR 20 to less than 40 stage group's improvement was $2.13{\pm}1.92$. $10.79{\pm}15.93$ and $0.10{\pm}0.26$ respectively. SOR 40 to less than 60 group's improvement was $2.16{\pm}2.24$, $9.80{\pm}16.62$ and $0.15{\pm}0.25$ respectively. Surgery group's improvement was $2.47{\pm}2.21$, $11.64{\pm}18.53$ and $0.15{\pm}0.27$ respectively (p<0.03). But there was no statistically significance between 6 group's improvement after treatment (p>0.05). Conclusions After inpatient treatment by Korean Medicine therapy, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically correlation between the degree of HIVD at L4-5 level and improvement of low back pain. So We think that future research of higher quality and correct statistics shall be necessary.