• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.84-89
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• 2020

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients' lifestyle.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.231-235
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• 2015

Damage to peripheral nerves or the spinal cord is often accompanied by neuropathic pain, which is a complex, chronic pain state. Increasing evidence indicates that alterations in the expression and activity of gap junction channels in the spinal cord are involved in the development of neuropathic pain. Thus, this review briefly summarizes evidence that regulation of the expression, coupling, and activity of spinal gap junction channels modulates pain signals in neuropathic pain states induced by peripheral nerve or spinal cord injury. We particularly focus on connexin 43 and pannexin 1 because their regulation vastly attenuates symptoms of neuropathic pain. We hope that the study of gap junction channels eventually leads to the development of a suitable treatment tool for patients with neuropathic pain.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.63-67
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• 2006

Background: Pain due to spinal stenosis is one of the major causes of low back pain, and it sometimes does not respond to conservative treatment. We postulated that anterior epidural irrigation could be a good choice for treating lumbar spinal stenosis patients. However, the effects and theoretical basis of anterior epidural irrigation have not been investigated for spinal stenosis. So, this study was designed to identify the clinical efficacy of anterior epidural irrigation for treating lumbar spinal stenosis. Methods: 71 patients with lumbar spinal stenosis underwent anterior epidural irrigation. Anterior epidural irrigation was performed with normal saline and a mixture of local anesthetic with steroid through a catheter under fluoroscopic guidance. The findings were evaluated with using visual analogue scales for low back pain and leg symptoms. Results: Relief from low back pain and leg pain was observed for up to 12 months after anterior epidural irrigation. None of the patients showed any deterioration of their motor or sensory deficits during follow up. Conclusions: Anterior epidural irrigation is effective for the relief of back and leg pain in spinal stenosis patients.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.2
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• pp.318-323
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• 2011

The purpose of this study identify that spinal decompression therapy effect on and pain, length Of leg distance(LLD), and muscle power and flexibility in patient with low back pain. The participants is 20 female and male with low back pain, and participant assign to decompression therapy group and control group at random. The decompression therapy apply to 20 minute 3 time for a week during 4 weeks. The Measurement items is pain, LLD, and muscle power, flexibility. The comparison between the before and after was Wilcoxon's U test, and 2 group after spinal decompression therapy application compared Mann-Whithney U test. Spinal decompression therapy reduced statistically significance the pain, LLD, and increased statistically significance the muscle power and flexibility increased the muscle power(p<.05). This study showed that spinal decompression therapy does affect pain, LLD, and muscle power and flexibility in patient with low back pain.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.123-126
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• 2006

Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.1-10
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• 2008

Spinal joint pain syndrome is composed of atlanto-occipital, atlanto-axial, facet, and sacro-iliac joints pain. The syndrome is characterized as referred pain which is originated from deep somatic tissues, which is quietly different from radicular pain with dermatomal distribution originated from nerve root ganglion. The prevalence of facet joint pain in patients with chronic spinal pain of cervical, thoracic, and lumbar regions has been known 56%, 42%, and 31% as in order. It is generally accepted in clinical practice that diagnostic blocks are the most reliable means for diagnosing spinal joints as pain generators. The sacroiliac joint has been shown to be a source of 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. The treatment of spinal joints ideally consists of a multimodal approach comprising conservative therapy, medical management, procedural interventions, and if indicated.

• Journal of muscle and joint health
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• v.29 no.3
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• pp.151-164
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• 2022

Purpose: The purpose of this study was to explore the illness experiences of patients who had spinal surgery. Methods: Colaizzi's phenomenological method was used for the data analysis. Patients who had spinal surgery were included in this study. The data was collected between April and October 2022 by conducting a one-on-one, in-depth interview. Results: Five theme clusters were identified based on the illness experiences of patients who had spinal surgery: "An agonizing life changed by pain", "Efforts to alleviate the pain", "Surgery was determined to be the best way to relieve pain", "Recovered daily life after relieving pain caused by surgery", and "Dedicated to living a healthy, pain-free life". The analysis further yielded 20 themes. Patients used various treatment methods to relieve pain, but ultimately chose surgery due to unbearable pain. Patients who had spinal surgery felt grateful that they were feeling good and healthy because they could return to their normal daily lives. After all, the pain was relieved after the surgery. Even though some pain remained unrelieved, the patients had the hope of getting better through exercise and rehabilitation. Conclusion: This study provides an in-depth understanding and meaning of the illness experiences of patients who had spinal surgery and presents new perspectives on clinical practice. The findings of this study are expected to be useful in developing and applying systematic and customized nursing interventions before and after spinal surgery.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.214-217
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• 2005

Spinal cord stimulation (SCS) was first attempted by Shearly et al for the relief of intractable pain. A spinal cord stimulator has traditionally been used for failed back surgery syndrome (FBSS) angina pectoris, complex regional pain syndrome (CRPS) and ischemic pain in the extremity. However, the complications associated with the use of a spinal cord stimulator, such as wound infection, hematoma, lead migration and device malfunction; make its long term application difficult. Here, our experience of an interesting case, in which intractable right leg pain was controlled using a spinal cord stimulator placed in the left epidural space, is reported, with a review of the literature.

• The Journal of Korean Physical Therapy
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• v.29 no.6
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• pp.299-302
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• 2017

Purpose: The purpose of this study was to examine the effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. Methods: Twenty patients with chronic low back pain were divided into an experimental group (spinal decompression therapy, n=10) and a control group (conservative physical therapy, n=10). Both groups were treated three times a week over a four-week period. Results: The comparison of between-group changes post-treatment revealed statistically significant lower levels of pain and disability in the experimental group than the control group. The comparison of within each group changes before and after the treatment showed statistically significant declines in pain and disability indexes of both groups. Conclusion: Spinal decompression therapy may be an effective intervention for improving pain and disability in patients with chronic low back pain.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.47-57
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• 2021

Background: Lumbar disc herniation (LDH) is a common cause of radicular pain, but the mechanism is not clear. In this study, we investigated the engagement of toll-like receptor 4 (TLR4) and the nuclear factor-kappa B (NF-κB) in radicular pain and its possible mechanisms. Methods: An LDH model was induced by autologous nucleus pulposus (NP) implantation, which was obtained from coccygeal vertebra, then relocated in the lumbar 4/5 spinal nerve roots of rats. Mechanical and thermal pain behaviors were assessed by using von Frey filaments and hotplate test respectively. The protein level of TLR4 and phosphorylated-p65 (p-p65) was evaluated by western blotting analysis and immunofluorescence staining. Spinal microglia activation was evaluated by immunofluorescence staining of specific relevant markers. The expression of proand anti-inflammatory cytokines in the spinal dorsal horn was measured by enzyme linked immunosorbent assay. Results: Spinal expression of TLR4 and p-NF-κB (p-p65) was significantly increased after NP implantation, lasting up to 14 days. TLR4 was mainly expressed in spinal microglia, but not astrocytes or neurons. TLR4 antagonist TAK242 decreased spinal expression of p-p65. TAK242 or NF-κB inhibitor pyrrolidinedithiocarbamic acid alleviated mechanical and thermal pain behaviors, inhibited spinal microglia activation, moderated spinal inflammatory response manifested by decreasing interleukin (IL)-1β, IL-6, tumor necrosis factor-α expression and increasing IL-10 expression in the spinal dorsal horn. Conclusions: The study revealed that TLR4/NF-κB pathway participated in radicular pain by encouraging spinal microglia activation and inflammatory response.