• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1683-1686
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• 2018

Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.183-191
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• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• The Journal of Korean Physical Therapy
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• v.23 no.4
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• pp.23-28
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• 2011

Purpose: To investigate the effects of hyperbaric oxygen therapy (HBOT) on chronic low back pain in elderly patients with impaired functioning in daily life. Methods: 35 subjects with chronic low back pain were randomly allocated into two groups, HBOT group and Placebo group. We applied TENS and mechanical massage to the lower back in both groups. Then 35% oxygen at 1.4 ATA was given to the HBOT group and atmospheric oxygen at 1 ATA to the placebo group. Results: Comparing the HBOT group with the placebo group after performing interventions six times in 2 weeks, a statistically significant difference in the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores was observed between the two groups. There was a statistically significant difference in VAS and ODI scores (56% and 34.97% respectively) between the HBOT group and the placebo group. A statistically significant difference was ascertained in the degree of variables VAS and ODI in the HBOT group. Conclusion: Application of HBOT in chronic low back pain could be beneficial for reducing pain and could help in functional recovery.

• Physical Therapy Korea
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• v.26 no.1
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• pp.51-59
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• 2019

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.109-115
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• 2018

Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.

• Journal of Acupuncture Research
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• v.23 no.5
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• pp.39-54
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• 2006

Objectives : Herniation of Nucleus Pulpous (HNP) of Lumbar is one of the most common causes of low back pain. The aim of this study is to investigate the effectiveness of acupuncture, bee venom acupuncture (BVA), and bee venom Pharmacopuncture (BVP) therapy for HNP. Methods : We separated 35 patients with HNP of L-spine into three groups; Acupuncture treated group, BVA treated group, and BVP treated group, and monitored for 30 days. 4 grades of recovery degree, score of Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) were examined for comparison. Results : 1. Visual Analogue Scale of low back pain and radiating pain showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_2, VAS0_3 evaluations. 2. ODI of disability of daily activities showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_1, VAS0_2, and VAS0_3 evaluations. 3. Compared to the Acupuncture group, BVA and BVP groups were improved in S.L.R.T and R.O.M of L-spine as confirmed by the physical examination. 4. Treatment efficacy was more apparent in acute cases as ODI was significantly lower than chronic cases. Conclusion : BVA and BVP therapies can be used in addition to the acupuncture therapy for highly effective treatment of HNP. Further clinical studies are required to verify these findings.

• Physical Therapy Korea
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• v.18 no.2
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• pp.9-17
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• 2011

The objective of this research was to examine the effects of lumber stabilization exercise and a general physiotherapy program for caregivers with chronic low back pain. Sixteen people participated in this study and were randomly assigned to two groups for either lumbar stabilization exercise or for general physiotherapy, respectively. The experiment was performed for eight weeks. To examine the general as well as the medical characteristics of the participants, the following measurements were used: Visual Analogue Scale (VAS); Oswestry Disability Index (ODI); Back Performance Scale (BPS); Roland - Morris Disability Questionnaire (RMDQ); and Beck Depression Index (BDI). To compare the general and medical characteristics of the participants in the two groups, an independent t test were used. During the experiment, a paired t test was conducted to determine whether there was a significant difference in the values of VAS, ODI, BPS, RMDQ, and BDI before and after the experiment. To examine the difference in the VAS, ODI, BPS, RMDQ, and BDI values in the two groups, ANCOVA was used with pre test values as a covariate. According to the test results, in the lumbar stabilization exercise group, the VAS, ODI, BPS, RMDQ, and BDI values showed a statistically significant difference before and after the test (p<.05). In comparison, in the general physiotherapy program group, only the ODI and BPS values showed a statistically significant level of improvement. Regarding the degree of improvement, participants in the lumbar stabilization exercise group showed statistically significant progress compared to those in the general physiotherapy group. In summary, lumbar stabilization exercise is regarded as more effective than general physiotherapy for treating caregivers with chronic low back pain. In future studies, it will be useful to expand the research and to examine the long term effects of lumbar stabilization exercise on workers.

• Journal of Acupuncture Research
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• v.28 no.4
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• pp.1-7
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• 2011

Objectives : The purpose of this study is to investigate the effectiveness of treating low back pain patients with Foot acupuncture. Methods : Clinical study was conducted to 40 patients who were treated in Dept. of Acupuncture and Moxibusion, Woosuk University Hospital from March 1 to December 31, 2010. Subject were randomly divided into two groups. In one group(test group), patients were treated with both acupuncture and Foot acupuncture. And in the other group(control group), patients were treated with acupuncture. To estimate the efficacy of treatments, Visual Analog Scale(VAS) and Oswestry disability index(ODI) were checked. 12 patients were excluded and we investigated 14 patients of control group and 14 patients of test group entirely. Results : 1. In both two groups, VAS and ODI of patients were decreased significantly. 2. ODI of patients in test group were decreased more significantly than ODI of patients in control group. Conclusions : We suggest that cotreatment of acupuncture and foot acupuncture on low back pain patients can be recommended as a useful therapy.

• The Korea Journal of Herbology
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• v.28 no.2
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• pp.75-82
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• 2013

Objective : This study was to evaluate the effectiveness of the prescription Dokhwalkigisaengtangagambang(DGG) and Gamisayuktanggagambang(GSG), which has been utilized in the treatment of joint disease, for improving low back and knee joint pain. Methods : In the patients for the clinical studies, control group was 28 cases, experimental group was 41 cases. All subjects had low back pain and knee pain. The experimental group was treated with DGG or GSG, the control group was treated with 17 prescriptions. VAS (Visual Analag Scale), WOMAC (Western Ontario and McMasters Universties Osteoarthritis Index) and ODI (Oswestry Low back pain Disability index) measured before and after the prescription administration. Results : In the difference of VAS score, the experimental group (p <0.001) and the control group (p <0.001) were decreased significantly before and after the administration of prescription, and in the comparisons between the experimental group and the control group, experimental group was decreased significantly compared to the control group(p = 0.008). In the WOMAC score, there was no significant difference between the experimental group and the control group. In the difference of ODI items score, lifting (p = 0.020) and sleeping (p = 0.028) index were decreased significantly before and after the administration of prescription. Conclusion : The results indicated that the prescription DGG and GSG can reduce knee pain and low back pain. This study will be helpful for improving joint disease.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.1
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• pp.63-73
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• 2013

Objectives: The purpose of this case is to investigate and report the effectiveness of korean Medicine treatment and Harpagophytum radix. Pharmacopuncture for the type 1 complex regional pain syndrome. Methods: One patient is admitted at Bu-Chun Jaseng Hospital of Korean Medicine, diagnosed as type 1 complex regional pain syndrome and treated with korean Medicine treatment and Harpagophytum radix. pharmacopuncture. This case is measured and assessed by Neumerical Rating Scale(NRS), Oswestry Low-back Pain Disability Index(ODI) and Manual Muscle Test(MMT). Results: After treatment, the intensity and frequency of complex regional pain is gradually decreased and the result of NRS, ODI, MMT showed improvement. Conclusions: As seen in this cases of type 1 complex regional pain syndrome, korean Medicine treatment and Harpagophytum radix. pharmacopuncture appear to be effective for the pain relief and musculoskeletal function recovery.