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.
Journal of The Korean Society of Integrative Medicine
/
v.12
no.2
/
pp.33-45
/
2024
Purpose : This study aimed to compare the effects of spinal manipulation combined with medication on low back pain (LBP), range of motion, and disability in patients with chronic LBP. Methods : Twenty patients with chronic LBP were included in this study. The participants were randomly assigned to the spinal manipulation with medication group (n=10) or the medication only group (n=10). The intervention group received spinal manipulation for 15 minutes, twice a week, and took medication twice a day for eight weeks. The control group received the medication twice daily for eight weeks. Pain intensity assessed using the visual analog scale (VAS), range of motion, and disability due to LBP assessed using the Oswestry disability index were measured before and after the intervention. Results : The intervention group showed a significant improvement in pain intensity compared to the control group (p<.05), and the intervention and control groups significantly improved low back pain after the intervention (p<.05). The intervention group showed a significant improvement in the range of motion in flexion, extension, right lateral flexion, left lateral flexion, and right rotation (p<.05). The intervention group also showed a significant improvement in the change of disability in total score, pain intensity, personal care, lifting and standing compared to the control group (p<.05). Conclusion : This study showed that the combination of spinal manipulation and medication can benefit patients with chronic LBP, as evidenced by significant improvements in pain intensity, ROM, and disability. These findings suggest that utilizing both spinal manipulation and medication can positively affect individuals with chronic LBP. The results of this study should be applied in clinical settings to optimize treatment outcomes in patients with chronic LBP.
This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.
Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.
Journal of the Korea Academia-Industrial cooperation Society
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v.14
no.6
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pp.2862-2868
/
2013
The purpose of this study was to investigate the relationship between neck pain and upper limb disability in patients with non-specific neck pain (n=132) recruited from physiotherapy departments in the Korea. Baseline neck pain/disability was measured using the Northwick Park Neck Pain Questionnaire (NPQ) and upper limb disability was measured using the Disabilities of Arm, Shoulder, Hand questionnaire (DASH). A range of baseline psychosocial variables were measured as potential confounding variables. Pairwise analysis revealed a positive correlation between NPQ score and DASH score (Pearsons' r=0.628, p<0.05). This study provides preliminary evidence that patients with severe neck pain/disability also report severe upper limb disability. The presence of severe neck pain or low pain self efficacy and high fear-avoidence beliefs questionnaire should clinicians towards a careful examination of upper limb function in patients presenting with neck pain. Our data suggest the upper limb disability may need to be addressed as part of the neck management process.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.10
no.1
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pp.103-116
/
2004
The purpose of this study was to investigate between low back pain scale and disability index owing to gait pattern. For the period of February 1 to February 29, 2004, we had conducted a questionnaire and direct interview with 100 persons lived in Daejeon. The result were as follows: 1. The stride length of experimental group. the male was $49.9{\pm}12.9cm$. the female $45.7{\pm}12.9cm$ and the width of feet, the male was $13.5{\pm}5.7cm$, the female $12.2{\pm}4.8cm$. 2. The Fick angle of all subjects was showed in external disposition, the left angle showed in asymmetry, the male was $11.0{\pm}5.7^{\circ}$, the female $8.5{\pm}1.3^{\circ}$. 3. The foot arch was similar to sex as a weight bearing and non-weight bearing, the male was $1.3{\pm}0.8cm$, the female $1.3{\pm}0.9cm$. 4. The impedimental index according to back pain grade, men was a lower than women, the male was $5.7{\pm}6.9$ and the female $7.2{\pm}5.3$. 5. The relation to difference between foot arch and disability index according to back pain grade as a weight bearing and non-weight bearing, the higher foot arch, the higher back pain grade was statistically significance(p<.05). 6. The relation between width of feet and disability index according to back pain grade, the wider width of feet, the higher back pain grade was statistically significance(p<.01). 7. The relation between stride length and disability index according to back pain grade, the wider stride length, the higher back pain grade was statistically significance(p<.05).
Journal of The Korean Society of Integrative Medicine
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v.8
no.4
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pp.29-38
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2020
Purpose : The purpose of this research was to investigate the effects of barefoot walking on the sandy beach on pain intensity, disability, motor function, sleep satisfaction, and quality of life in the elderly with low back pain (LBP). Methods : A single-blinded randomized controlled trial was conducted involving 32 elderly with LBP who underwent sand walking barefoot (intervention, n=16) or with sneakers (control, n = 16). Both walking methods were carried out for 30 minutes per day, three times a week for four weeks. Pain intensity and disability were assessed using the visual analog scale and Oswestry disability index, respectively. Balance and gait were evaluated using the Berg balance scale and timed up and go test, respectively. Sleep satisfaction was quantified with the Verran and Snyder-Halpern sleep scale. Finally, quality of life was assessed through the WHO quality of life scale's abbreviated Korean version. Results : Compared with the control group, the intervention group showed significant differences in pain intensity (p=.005), disability due to LBP (p=.002), static balance ability (p=.003), dynamic balance ability (p=.002), and sleep satisfaction (p=.017). There was no significant difference in the quality of life between the two groups. Conclusion : Barefoot walking on a sandy beach is significantly effective in improving pain, disability due to LBP, balance ability, and sleep satisfaction in the elderly with LBP. Further studies with larger sample sizes and longer intervention periods must to be conducted to generalize using barefoot walking in LBP management.
Objective: The purpose of this study was to investigate the effects of myofascial decompressiontherapy using moving suction on body temperature, pain, neck disability index, and cervical rotation for young adult with nonspecific neck pain. Design: Two-group pretest-posttest design. Methods: The subjects were randomly assigned 22 patients with chronic cervical pain who met the study conditions to the experimental group (n=11) and the control group (n=11). In the experimental group, the myofascial decompressiontherapy (MDT) was performed for 10 minutes using moving suction withnegative 15 mmHg pressure from the insertion to the origin of the upper trapezius muscle, while the control group without negative pressure. In order to investigate the effects of the intervention, an infrared thermometer, a visual analogue scale, neck disability index, and goniometer were used. Results: As a result of comparing the pre- and post- changes in each group according to the intervention, skin temperature, pain, neck disability index, and cervical rotation in both the experimental and control groups were significantly improved (p<0.05). Comparison of pre- and post- changes between the experimental and control groups showed significant differences for pain and cervical rotation (p<0.05), but no significant difference was found in the body temperature and neck disability index. Conclusions: Based on the results, MDT using moving suction was effective in reducing pain and increasing of cervical rotation for young adult with nonspecific neck pain.
Purpose: The purpose of study was to investigate the effects of combination patterns exercise of Proprioceptive Neuromuscular Facilitation (PNF) on unstable surfaces on pain, functional disability, and fear avoidance belief in patients with chronic low back pain. Methods: Twenty four patients were assigned to either the experimental group (n=12) or the control group (n=12). Patients in the experimental group performed combination patterns exercise of PNF on unstable surfaces. Patients in the control group performed combination patterns exercise of PNF on stable surfaces. Both exercises were performed for five days per week, for a period of six weeks. Pain was measured by the Visual Analogue Scale (VAS) and University of Alabama at Birmingham (UAB). Functional disability was measured using the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ). Fear avoidance belief was measured using the Fear Avoidance Beliefs Questionnaire (FABQ). A paired t-test was used for determination of differences before and after treatment, and an independent t-test was used for determination of differences between treatment groups. Results: In within group comparison, the experimental group showed statistically significant difference for all variables (p<0.05). In comparison between two groups, the experimental group showed relatively greater significant difference for all variables (p<0.05). Conclusion: Based on such results, it can be said that combination patterns exercise of PNF on unstable surfaces has an effect on pain, functional disability, and fear avoidance belief in patients with chronic low back pain.
Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.
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