• Title/Summary/Keyword: Pelvic pain

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Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Superior Hypogastric Plexus Blocks for Malignant Pelvic Pain (상 하복신경총 차단을 이용한 골반내 통증관리)

  • Kang, Sung-Hee
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.108-112
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    • 1992
  • Pain from pelvic cancer is very difficult to manage because it's vague ness and bilateral nature. Furthermore, nerve blocks in this area are dangerous because sensory afferent nerves from pelvic viscera are adjacent to nerves that regulate bowel and bladder control, and motor nerve of lower extremities'. Bilateral lumbar sympathectomy has been used for malignant pelvic pain with little risk of neurologic complication. However it is not a specific block for pelvic visceral pain, because the lumbar sympathetic chain does not innervate pelvic viscera in a direct manner. Therefore the potentials of lumbar sympathectomy for pelvic visceral pain are attributed to caudad diffusion of neurolytic agents to the smperior hypogastric plexus. I have experienced 3 cases of superior hypogastric plexus neurolysis per se without any significant complications.

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Reliability and Validity of the Measurement of Pelvic Movement in Low Back Pain Patients using Cushion Sensor in Sitting Position (앉은 자세에서 방석센서를 이용한 요통환자 골반가동성 측정의 신뢰도와 타당도)

  • Jung, Seung-Hwa;Park, Dae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.2
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    • pp.83-91
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    • 2020
  • PURPOSE: Postural and structural asymmetry due to muscle imbalances around the lower back and pelvis are the causes of back pain. Muscle imbalances in patients with chronic low back pain affect the pelvic tilt and movement, and it is necessary to assess the pelvic movement ability using the appropriate tools to determine the mediating effects of lower back pain. This paper reports the reliability and validity of the Sensbalance Therapy Cushion (STC) for pelvic movement and proprioception. METHODS: In this study, the Wii balance board (WBB) was used as a golden standard for pelvic movement measurements. FABQ, KODI, Myovision, and Pelvic movement were measured in 50 patients with chronic low back pain. The correlation between the lower-back muscle activity and pelvic movement was checked. The pelvic movement parameter was measured twice to determine the intra-rater reliability. RESULTS: The STC showed high test-retest reliability in the pelvic tilt measurements (ICC = .672 - .809). The test-retest reliability of proprioception measurements (ICC = .588 - .859) and reaction time measurements (ICC = .542 - .836) were also high. The relationship between the WBB and STC showed a significant positive correlation with the pelvic tilt test (p < .01). The posterior pelvic tilt and lower-back muscle activity showed a significant negative correlation (p < .01). The pelvic left tilt and lower-back muscle activity showed a significant negative correlation (p < .05). CONCLUSION: The results revealed the high reliability and validity of the STC. Therefore, the STC can be used as an objective measuring device for evaluating pelvic tilt, proprioception, and reaction time in low back pain patients.

Effects of Active Release Technique on Pain, Oswestry Disability Index and Pelvic Asymmetry in Chronic Low Back Pain Patients (능동이완기법이 만성 허리통증 환자의 통증, 요통장애지수 및 골반비대칭에 미치는 영향)

  • Lee, Seung-Hoo;Nam, Seung-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.133-141
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    • 2020
  • PURPOSE: This study examined the effects of active release technique on pain, Oswestry Disability Index, and pelvic asymmetry in chronic low back pain patients. METHODS: Thirty five outpatients diagnosed with chronic low back pain were enrolled in this study. The patients were divided randomly into an active release technique therapy group(experimental group; n=18) and myofascial release technique therapy group(control group; n=17). These groups performed their respective therapy for a 40-minute session occurring twice a week over six weeks. The Visual Analogue Scale(VAS) was used to measure the subjects' pain, and the Korean Oswestry Disability Index(KODI) was used to measure the subjects' dysfunction. To assess the patients' pelvic asymmetry, their pelvic tilt and pelvic rotation were measured using X-ray imaging. RESULTS: Both the experimental group and control group exhibited significant decreases in their VAS and KODI scores after the therapy(p<.05). The experimental group exhibited a significant decrease in their pelvic tilt and pelvic rotation after therapy(p<.05). A significant difference was observed between the experimental group and the control group (p<.05). CONCLUSION: These results suggest that active release technique is effective in decreasing the level of pain and dysfunction in chronic low back pain patients. In addition, the active release technique is considered to be more effective in improving the pelvic tilt and pelvic rotation than myofascial release technique. This can be an effective method for the non-pharmacological and non-surgical treatment of chronic low back pain.

Transdiscal Superior Hypogastric Plexus Block for Postparaplegic Pelvic Pain (골반통을 동반한 하지마비환자에서 경추 간판적 상 하복신경총 차단 -증례 보고-)

  • Moon, Dong-Eon;Choi, Mee-Kyung;Suh, Jae-Hyun;Kim, Sung-Nyeun
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.277-281
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    • 1994
  • Both pelvic pain associated with cancer and chronic benign conditions may be alleviated by blocking the superior hypogastric plexus. Traditional bilateral placement of needles is the appropriate technique for the patient with pelvic pain due to the bilateral distribution of the disease as well as allowing for individual difference of pelvic cavity. However the technique is a very difficult procedure and painful for the paient. However we have performed transdiscal superior hypogastric plexus neurolysis free of complication.

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Effects of the Pelvic Control Method on Abdominal Muscle Activity and Lumbopelvic Rotation Angle during Active Straight Leg Raising in Patients with Chronic Low Back Pain (만성요통환자의 능동 하지직거상 동작 시 골반조절 방법에 따른 복부 근활성도와 요골반부 회전각도에 미치는 영향)

  • Kim, Dae-Hyun;Park, Jin
    • PNF and Movement
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    • v.18 no.2
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    • pp.223-231
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    • 2020
  • Purpose: The purpose of the study was to compare the effects of different methods of pelvic control on abdominal muscle activity and lumbopelvic rotation angle during active straight leg raising (ASLR) in patients with chronic back pain. Methods: The study participants were patients with low back pain (n = 30). They were instructed to perform ASLR with pelvic control, ASLR with pelvic belt, and ASLR only. Surface electromyography data were collected from the ipsilateral rectus femoris (IRF), ipsilateral internal oblique (IIO), contralateral external oblique (CEO), and ipsilateral rectus abdominal (IRA) muscles, and lumbopelvic rotation angle was measured using a motion analysis device. Results: Activation of all abdominal muscles was greater in the ASLR with pelvic control group than in the ASLR with pelvic belt and ASLR groups. The lumbopelvic rotation angle was lower in the ASLR with pelvic control group than in the other two groups (p < 0.05). Conclusion: These results suggest that ALSR with pelvic control is an effective means of increasing abdominal muscle activity and reducing unwanted lumbopelvic rotation in patients with chronic low back pain. Controlling the pelvis using the opposite leg is an effective form of ASLR exercise for patients with chronic low back pain.

A New Technique for Inferior Hypogastric Plexus Block: A Coccygeal Transverse Approach -A Case Report-

  • Choi, Hong-Seok;Kim, Young-Hoon;Han, Jung-Woo;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.38-42
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    • 2012
  • Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.

Effects of Active Release Technique and Lumbar Stabilization Exercise on Pelvic Asymmetry, Muscle Activation and Pain in Chronic Low Back Pain Patients (능동이완기법과 허리안정화 운동이 만성허리통증 환자의 골반비대칭, 근활성도 및 통증에 미치는 영향)

  • Nam, Seungmin
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.147-157
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    • 2020
  • Purpose : The purpose of this study was to investigate the effects of active release technique and lumbar stabilization exercise on pelvic asymmetry, muscle activation and pain in chronic low back pain patients. Methods : The subjects were 37 outpatients diagnosed with chronic low back pain. The patients were randomly divided into an active release technique therapy group (ART; n=18), and lumbar stabilization exercise group (LSE; n=19). These groups performed their respective therapy for a 30-minute session occurring two times a week over six-weeks period. To assess the patients' pelvic asymmetry, their pelvic tilt, and pelvic rotation was measured using X-ray imaging. EMG was used to evaluate the muscle activity of the lumbar muscle. The visual analogue scale (VAS) were used to measure the subjects' pain. Results : Both ART group, and LSE group exhibited statistically significant differences in their subjects' VAS and muscle activation of lumbar muscle after the therapy (p<.05). In ART group exhibited statistically significant decreases in their subjects' pelvic tilt and pelvic rotation after therapy (p<.05). There was a significant difference between the ART group, and LSE group (p<.05). Conclusion : The results of this study suggest that active release technique and lumbar stabilization exercise are effective in decrease pain and increase muscle activation in chronic low back pain patient. In addition active release technique is considered to be more effective in improving pelvic tilt and pelvic rotation than lumbar stabilization exercise.

Case study of application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance (골반 불균형에 의한 편측체중지지 요통환자의 골반도수교정 적용사례)

  • Kim, Han-Il;Kim, Sang-Su;Kim, Gee-Sun;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.72-78
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    • 2009
  • Purpose: to recognized that influence of decrease low back pain, change pelvic structure and balance control on unilateral weight bearing after application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance. Methods: The patient with low back pain in unilateral weight bearing due to pelvic imbalance was 39year female. one subject received intervention of pelvic manipulation on sidelying position and reaching exercise on sitting position which during 2 weak at the 3 time per a weak, each 30 minutes. outcomes measured were Facia l Action Coding System(FACS), Radiograph(Lumbar-Spine Anteroposterior AP.), Pressure Scan. Results: The results of this study were summarized below : 1. FACS score were Pre: min.4 - max.6 and Post: min.2 - max.4. 2. Radiograph measured Ilium width were Pre: Lt.14cm, Rt.12.7cm and Post: Lt.13.4cm, Rt.13cm which discrepancy of Ilium height were Pre: 1cm and Post: 0.2cm. 3. Pressure scan measured Pre: Lt. 36.8%, Rt.40.2% and Post: Lt.41.3%, Rt.36.2%. Conclusion: Pelvic manipulation applied a patient with low back pain in unilateral weight bearing due to pelvic imbalance suggest that can decrease low back pain, change pelvic structure and balance control on unilateral weight bearing.

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A Clinical Study on 1 Case of Postpartum Patient with Pelvic Girdle Pain (추나 수기 치료를 병행하여 호전된 산후 골반통 환자 치험 1례)

  • Choi, Kyung-Hee;Jung, Eun-Hye;Kwon, Ji-Myung;Yoo, Dong-Youl
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.4
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    • pp.204-212
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    • 2013
  • Objectives: The purpose of this study is to report the effects of traditional Korean treatment (acupuncture, herb medicine and Chuna manipulation treatment) on a postpartum patient with pelvic girdle pain. Methods: The postpartum patient with pelvic girdle pain was treated by traditional Korean treatment such as herbal medication (Boheotanggagam-bang), acupuncture. The patient was diagnosed pelvic insufficiency in pelvis AP x-ray. So we treated the patient a total of 10 times of acupuncture and Chuna manipulation treatment. Results: After the treatment, the patient's pain was disappeared and the pelvic insufficiency in pelvis AP x-ray was improved. Conclusions: This case shows that traditional Korean treatment might be effective in improving postpartum patients' pain and pelvic insufficiency.