We report a 66-year-old woman with complex regional pain syndrome (CRPS) 1 treated with combined medical and active physical therapy. She was diagnosed with CRPS 1 following partial shoulder prosthesis due to proximal humerus fracture. Despite continuous medication and physical therapy, there was no improvement in her pain and functional outcome. Her overall pain was decreased by stellate ganglion block 3 times in two weeks conducted during the second month of the follow-up period. Following the ganglion blockades, pain and the other symptoms were decreased intermittently but range of motion (ROM) and functional status were not satisfied as much as expected. After the third month of follow-up, her passive and active ROM of the shoulder joint was increased after application of manipulation under general anesthesia. In conclusion, because CRPS 1 remains one of the most difficult pain syndromes, early diagnosis and treatment are important to have adequate functional results from physical therapy. Manipulation under general anesthesia may be an additional effective treatment tool to obtain functional improvement in some patients diagnosed with CRPS 1.
Objective: The aim of this study is to test the effects of elastic band exercise accompanied by Swiss ball exercise on lower limb muscle strength, balance and pain in middle-aged women with osteoarthritis. Design: A randomized controlled trial. Methods: Thirty-five participants were randomly assigned to the experimental group (n=18), which performed elastic band exercise combined with Swiss ball exercise, and the control group (n=17), which performed elastic band exercise only. Both groups did a 30-minute session of exercise three times a week for eight weeks and were assessed for lower extremity muscle strength, static and dynamic balance, and pain levels before the first therapy session. All participating patients underwent outcome assessment after eight weeks of therapy without any additional treatment. Results: The experimental group made a significant increase in muscle strength of the lower extremities, static and dynamic balance ability, and pain level (p<0.05). The control group made a significant improvement in lower limb muscle strength, dynamic balance ability and pain level (p<0.05) with no such improvement in static balance ability. The exercise group made a significant increase in static and dynamic balance ability and pain level compared to the control group (p<0.05). Conclusions: These results demonstrated that both Swiss ball exercise and elastic band exercise were effective for middle-aged women with osteoarthritis and found that elastic band exercise combined with Swiss ball exercise produced more significant effects on their balance and pain.
Objective: The objective of this study was to investigate the effect of the thoracic mobility exercise program on pain, proprioception, and static balance ability in patients with non-specific chronic low back pain. Design: Randomized controlled trial design. Methods: Thirty patients with non-specific chronic low back pain participated in this study. The participants were randomized into the thoracic mobility exercise group (n=15) and the lumbar stabilization exercise group (n=15). Both groups received traditional physical therapy for 30 minutes per session. In addition, the thoracic mobility exercise group and the lumbar stabilization exercise group each exercise 3 times a week for 6 weeks. All participants were measured visual analog scale, proprioception test, and static balance ability before and after the intervention. Results: After 6 weeks of interventions, the thoracic mobility exercise group showed greater improvement in visual analog scale, proprioception test, and static balance ability than the LSE group (p<0.05). Further, the thoracic mobility exercise group had significant Enhancements in all measured variables compared to the baselinetest (p<0.05). However, the lumbar stabilization exercise group had significant improvement only visual analog scale, and static balance ability compared to the baselinetest (p<0.05). Conclusions: Our investigation demonstrates that the thoracic mobility exercise is an effective intervention method for improving pain, proprioception, and static balance ability in patients with non-specific chronic low back pain.
Han, Kyung Ream;Kim, Chan;Yang, Jong Yoon;Han, Seung Tak;Kim, Yeui Seok
The Korean Journal of Pain
/
v.19
no.1
/
pp.56-62
/
2006
Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.
Hazer, Derya Burcu;Acarbas, Arsal;Rosberg, Hans Eric
The Korean Journal of Pain
/
v.31
no.2
/
pp.109-115
/
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.
Yaksi, Elif;Ketenci, Aysegul;Baslo, Mehmet Baris;Orhan, Elif Kocasoy
The Korean Journal of Pain
/
v.34
no.2
/
pp.217-228
/
2021
Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients' visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.
Objectives: The purpose of this study is to investigate the clinical effects of heating-conduction therapy on lateral ligament injury induced by ankle sprain grade II. Methods: The 67 outpatients who were diagnosed as ankle sprain grade II were performed heating-conduction acupuncture therapy on lateral ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied pretreatment and after 1st, 2nd treatment. Results: 1. The pain threshold and VAS score after 1st and 2nd treatment with an isolated injury of the anterior talofibular ligament showed statistically significant improvement compared with pretreatment. 2. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular and the calcaneofibular ligament showed statistically significant improvement compared with pretreatment. 3. The VAS score after 1st and 2nd treatment with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament showed statistically significant improvement compared with pretreatment. 4. After 1st and 2nd treatment on the posterior talofibular ligament and after 2nd treatment on the anterior taofibular and calcaneofibular ligament with an combined injury to the anterior talofibular, calcaneofibular and posterior talofibular ligament the pain threshold showed statistically significant improvement compared with pretreatment. 5. Between isolated injury and combined injury of lateral ligament, the difference in pain threshold and VAS score was not statistically significant. Conclusions: Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with an isolated injury and combined injury of lateral ligament induced by ankle sprain grade II.
Objectives: This study explored the relationships between Bone Mineral Density (BMD), Body Mass Index(BMI), Age, pain duration outcomes of treatment for Low Back Pain(LBP) in 3 groups(normal,osteopenia,osteoporosis) of female patients. Methods: We evaluated 32 cases of normal, 30 cases of osteopenia and 38 cases of osteoporosis based on BMD, BMI, Age, pain duration among the female inpatients with LBP caused by lumbar disc herniation, admitted at Jaseng Hospital of Oriental Medicine from January 2010 to December 2011. And we measured VNRS(Verbal Numeric Rating Scale) to evaluate the conservative treatment effects. Results: In improvement of female LBP caused by lumbar disc herniation, BMD(T-score), BMI had not proved correlation(P-value>0.05). Female patients' age was negatively correlated with T-score. In pain improvement, BMD normal group showed more reduction of NRS(numeric rating scale) than osteoporosis group, but that had not proved correlation(p-value=0.893). Conclusions: Statically, among the female inpatients with LBP caused by lumbar disc herniation, had no significant differences between the normal group, osteopenia group and osteoporosis group's improvement rate, depending on treating period.
Donohue, Nicholas K.;Tarima, Sergey S.;Durand, Matthew J.;Wu, Hong
The Korean Journal of Pain
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v.33
no.2
/
pp.192-198
/
2020
Background: Previous studies have shown varying results between lumbosacral transforaminal epidural steroid injections (TFESIs) performed with particulate versus non-particulate corticosteroids. The purpose of this study was to investigate the difference in pain relief and functional improvement between particulate and nonparticulate lumbosacral TFESIs in patients who had undergone both injections, sequentially. Methods: This was a self-controlled, retrospective study of 20 patients who underwent both a methylprednisolone and a dexamethasone TFESI to the same vertebral level and side. Primary outcomes included pain relief according to the visual analogue scale (VAS) and functional improvement determined by a yes/no answer to questions regarding mobility and the activities of daily living. Post-injection data was recorded at 2, 3, and 6 months. Results: A decrease in VAS scores of -3.4 ± 3.0 (mean ± standard deviation), -3.1 ± 3.1, and -2.8 ± 3.4 was seen for the methylprednisolone group at 2, 3, and 6 months, respectively. Similar decreases of -3.9 ± 3.5, -3.4 ± 2.8, and -2.3 ± 3.4 were seen in the dexamethasone group. There was no significant difference in pain relief at any point between the two medications. The percentage of subjects who reported improved function at 2, 3, and 6 months was 65%, 51%, and 41%, respectively, for the methylprednisolone group and 75%, 53%, and 42% for the dexamethasone group. Conclusions: These findings support the use of non-particulate corticosteroids for lumbosacral TFESIs in the context of documented safety concerns with particulate corticosteroids.
The main purpose of this study is to evaluate the effects of manual therapies which are Posterior Anterior Central Vertebral Pressure (PACVP) and Posterior Anterior Unilateral Vertebral Pressure(PAUVP} in patients having a chronic pain in the neck. This study focused on sixty patients having a chronic pain in the neck from 19 years old and 65years old. There are 33 females and 27 males each. This study randomize two groups from all subjects that have been mentioned above. Group 1 received a cervical spine manual therapy, Group 2 received a conservative physical therapy. Each therapy was held for 3 times a week, totally, 6 times for two weeks. The tape was used to measure cervical range of motion(ROM) in six areas-flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation. 100mm Visual Analogue Scale(100mm VAS) was used to measure the subjective pain level. All measurements of each patient were measured at pre-treatment and 2 weeks post-treatment. The results of this study would be summarized as follow: 1. The manual treatment group has much more recovery than that of conservative physical therapy group in terms of the degree of the ROM improvement showing a significant difference between two groups(p<0.05) 2. The manual treatment group has more recovery than that of the conservative physical therapy group in the improvement of pain(p<0.05).
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