• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.158-163
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• 2017

Purpose: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. Methods: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired t-test was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. Results: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=-0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=-0.692, p<0.05). Conclusion: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.

• Journal of the Ergonomics Society of Korea
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• v.29 no.6
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• pp.889-895
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• 2010

This study compared the effects of craniocervical flexion exercise with conservative cervical flexion exercise in workers with chronic neck pain. Subjects were randomly allocated to two groups: control (n=20) and experimental group (n=20), respectively. The conservative exercise for the control group consisted of cervical flexion exercise, whereas the experimental group performed a craniocervical flexion exercise. To compare the two groups, the visual analogue scale (VAS) for a pain, neck disability index (NDI) for a neck disability scale, and cross sectional area (CSA) of longus colli muscle using ultrasound image were assessed on pre-intervention, post-intervention, and 2 weeks follow-up. 2-way repeated ANOVA was used with Bonferroni post-hoc test. (1) There were significant main effects (within and between groups) (p<0.05) and interaction effect (p<0.05) in VAS. Post-hoc test revealed that there were significant differences in all pair-wise comparisons. (2) There were significant main effects (within and between groups) (p<0.05) and interaction effect (p<0.05) in NDI. Post-hoc test revealed that there were significant differences between pre-intervention and post-intervention, pre-intervention and 2 weeks follow-up. (3) There were significant main effects (within and between groups) (p<0.05) and interaction effect (p<0.05) in CSA of longus colli muscle. Post-hoc test revealed that there were significant differences in all pair-wise comparisons. The findings indicate that craniocervical flexion exercise are more effective for improving pain, neck disability, and CSA of longus colli muscle than cervical flexion exercise in workers with chronic neck pain.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.33-44
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• 2018

Purpose: The primary purpose of this study was to investigate the effects of cervical stabilization exercise (CSE) on hamstring flexibility in patients with neck pain. A secondary purpose of this study was to investigate the effects of cervical range of motion (CROM) and craniovertebral angle (CVA). Methods: This study was a single-blind, randomized, comparative trial. Twenty patients were allocated into either the cranio-cervical flexion exercise (CCFE) group or the CSE group. Before and after the intervention, we measured straight leg raise (SLR), popliteal angle (PA), CROM, and CVA in the sitting and standing positions. Fisher's exact test, the Mann-Whitney test, and Wilcoxon's signed-rank test were used to analyze our data. Results: Both groups showed significant improvements in the value of SLR, PA, cervical extension, cervical rotation, and CVA in the standing position (both, p<.05) after intervention. However, only the CSE group showed significant improvements in cervical right lateral flexion (z=-2.209; p<.01) and cervical left lateral flexion (z=-2.537; p<.05) after intervention. The CSF group showed more significant improvements in SLR, PA, both cervical lateral flexions, and both cervical rotations than the CCFE group. Conclusions: The results of this study will guide future research in identifying the effectiveness of CSE. In conclusion, it can be inferred that CSE has a positive effect on SLR, PA, CROM, and CVA in the standing position in patients with chronic neck pain.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.67-75
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• 2016

Objectives The purpose of this study was to investigate the clinical usefulness of M-test (Meridian test) as an adjunctive evaluation and treatment in patients with chronic neck pain. Methods This study was a single arm pre-post comparison study. Thirty-six eligible subjects with chronic neck pain were recruited from August to September, 2015. M-test was used for evaluating the condition of meridian, which can induce the limitation of ROM and body discomfort. Subjects were offered intradermal acupuncture treatment on one-acupoint for 48 hours. Cervical numeric rating scale (NRS), cervical range of motion (ROM), neck disability index (NDI) and surface electromyography (SEMG) were measured before and after the treatment. Total NRS and the number of movement limitation of M-test were also measured before and after the treatment. Results Among the 36 participating subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on Cervical NRS and NDI were found after the treatment (p<0.001). There was a significant difference in the range of left cervical rotation (p<0.05). Root mean square (RMS) of SEMG significantly decreased on the right sternocleidomastoid muscle (p<0.05), but significantly increased on the right trapezius muscle (p<0.05). Median frequency (MdF) of SEMG significantly increased on both sternocleidomastoid muscles. There appears to be significant differences after the treatment in total NRS and the number of movement limitation of M-test (p<0.05). Conclusions These results suggest that the evaluation and treatment of M-test based on the meridian and collateral theory were effective on cervical NRS and NDI, and also improved the movability of human body.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• The Korean Journal of Pain
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• v.37 no.3
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• pp.256-263
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• 2024

Background: Cervical epidural block (CEB) is an effective intervention for managing cervical radicular pain. This study aimed to investigate the current status of performing CEB in South Korea. Methods: Pain physicians affiliated with the Korean Pain Society were asked to complete anonymous questionnaires regarding CEB between September and October 2022. The questionnaire consisted of 24 questions assessing the current status and methods of CEB in detail. Results: Of the 198 surveys collected, 171 physicians (86.4%) reported performing CEB. Among those, the majority (94.7%) used fluoroscopy during the procedure. The paramedian interlaminar (IL) approach was the most preferred method (50.3%). Respondents performing fluoroscopic-guided IL CEB were categorized into two groups based on clinical experience: those with ≤10 years of experience (≤10-year group, n = 91) and those with >10 years of experience (>10-year group, n = 71). The proportion of physicians obtaining informed consent in the ≤10-year group and >10-year group was 50.5% and 56.3%, respectively. When entering the epidural space during IL CEB, the contralateral oblique view was the second most frequently used in both groups (≤10-year group, 42.9%; >10-year group, 29.6%). In targeting the upper cervical lesions (C3-4), the proportion of respondents who used an IL space higher than C6-7 was 17.6% in the ≤10-year group and 29.5% in the >10-year experience group. Conclusions: This study demonstrated variability in the CEB technique used by pain physicians in South Korea. The findings highlight the need for education on informed consent and techniques to enhance safety.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.2
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• pp.105-111
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• 2013

Objectives : The purpose of this study is to evaluate the Korean medical treatment for chronic tension-type headache, especially chuna manual therapy on cervical vertebrae. Methods : One patient was treated with acupuncture, herbal medication and chuna manual therapy on cervical vertebrae. To evaluate the pain of head and neck, visual analog scale(VAS) was measured. Results : After treatment for 1 week, the pain of head and neck was declined from VAS 10 to VAS 3. Conclusions : Korean medical treatment including acupuncture, herbal medication and cervical chuna manual therapy is effective for chronic tension-type headache. But further studies are required to prove the effectiveness of chuna manual therapy on cevical vertebrae.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.114-118
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• 1999

Backgrouds: Cervical epidural blocks were used as part of a comprehensive multimodal treatment program for patients with chronic pain in the head, neck and upper extremities. The depth of the epidural space beneth the skin surface varies at different levels of the spinal column in the same patient. It also varies from patient to patient at the same vertebral level. We studied the distance the skin to the cervical epidural space in adults patients at different intervertebral spaces. Methods: Date were gathered from 628 patients having cervical epidural block for relief of cervical and upper extrimity pain. All blocks were performed using hanging drop method after loss of resistance with saline at C5-6, C6-7, C7-T1 intervertebral space. Results: Mean distances for skin to cervical epidural space (DSES) were 5.42 cm, 5.06 cm, 4.68 cm in male, 5.00 cm, 4.61 cm, 4.10 cm in female at C7-T1, C6-7, C5-6 intervertebral space. DSES correlated with body weight, neck circumference and body mass index significantly. Conclusion: In the cervical spine, DSES varies from space to space. The longest DSES were noted at C7-T1 level in male, and the shortest DSES were at C5-6 in female. DSES has significant relationships with weight, neck circumference and body mass index.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.9-14
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• 2014

Background: Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient experiencing cervical radiculopathy. Methods: In this study, 30 participants who met the diagnostic criteria for cervical radiculopathy were randomized into two groups: group I (nerve mobilization group) & group II (Mckenzie exercise group). The experimental group was performed manual cervical traction and neural mobilization technique. The control group was performed manual cervical traction and cervical retraction, extension exercise. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were pain intensity (PI), cervical rotation ROM (CR) and neck disability index (NDI). Results: After 4 weeks therapy, PI, CR and NDI were significantly reduced in both groups (p<.01). The PI, CR and NDI were no significantly reduced between group I and group II (p>.01). Conclusions: Manual therapy could reduce the symptoms of cervical radiculotpathy.

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.419-422
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• 2006

Objective : Radiofrequency facet rhizotomy[RFFR] has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome[CDRS]. To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. Methods : The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain [33 cases], herniated nucleus pulposus [6], foraminal stenosis [4], and compression fracture [1]. The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair of poor. Treatments were considered successful if the therapeutic results were graded as either excellent of good. Results : The overall success rate in all patients was 72.7%. The success fate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results [mean success rate was 27.3%]. Some patients complained of transient hypesthesia [4 cases] of transient dull pain at the electrode insertion sites [2 cases]. Conclusion : RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.