• 제목/요약/키워드: chronic pelvic pain

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골반 염증성 질환에 관한 고찰 (A Study on Pelvic Inflammatory Disease)

  • 이보라;유동열
    • 혜화의학회지
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    • 제17권2호
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    • pp.155-160
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    • 2008
  • Pelvic inflammatory disease (PID) is a general term that refers to infection of the internal reproductive organs such as the female uterus, fallopian tubes, and ovaries. PID is caused by germs that invade the genital organs, causing the acute inflammatory reaction, and chronic PID is to have a recurrence of PID because of the lack of effective treatment of acute PID. Symptoms of PID include pelvic pain, fever, leukorrhea, infertility, and fatigue. Treatments for PID can be improved by combining herb medicine therapy, intestinal irrigation, or the therapy that put herb medicine on the abdominal region with antibiotics, or analgesic drugs.

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수정된 복부 드로우-인 기법이 만성요통 환자의 몸통 안정성과 기능, 통증에 미치는 영향 -사례연구- (Effects of Modified Abdominal Draw-in Maneuver on Trunk Muscle Stability and Functional Capacity and Pain in Patients with Chronic Low Back Pain)

  • 김창범
    • PNF and Movement
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    • 제15권3호
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    • pp.217-226
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    • 2017
  • Purpose: The purpose of this study was to determine the effects of a modified abdominal draw-in maneuver on trunk stability and functional capacity as well as pain in patients with chronic low back pain. Methods: The study included 3 patients with chronic low back pain who volunteered to participate. The modified abdominal draw-in maneuver included a posterior pelvic tilt, a traditional abdominal draw-in maneuver, and a vibration sensory feedback device. Voluntary abdominal contraction using the vibration sensory feedback device was performed by the subjects for more than 1 hour per day, 5 times per week, for 6 weeks along with common low back pain treatment. Electromyographic signals in the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were measured to compare muscle activation. The degree of pain was measured using the visual analogue scale (VAS), and functional capacity was measured using the Korea Oswestry Disability Index (K-ODI). All results were compared to the means before and after intervention. Results: After the intervention, the RA, EO, and IO showed increased muscle activation and the ES showed decreased muscle activation. The visual analogue scale decreased after intervention and the K-ODI decreased after intervention. Conclusion: Modified abdominal draw-in maneuvers in daily life combined with therapeutic exercises may be effective in relieving pain and dysfunctions in chronic low back pain patients.

만성 골반통의 한의약 치료 : 무작위 대조군 연구에 대한 문헌 고찰 (Interventions of Korean Medicine for Chronic Pelvic Pain: a Literature Review of Randomized Controlled Trials)

  • 정원춘;박장경;성수현;황현호;정태영;박종현
    • 대한한방부인과학회지
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    • 제32권4호
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    • pp.102-115
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    • 2019
  • Objectives: This study aimed to review randomized controlled trials (RCTs) on the effects of interventions of Korean medicine for chronic pelvic pain (CPP). Methods: We searched eleven electronic databases from inception up to Apr 2018. RCTs evaluating the effects of Korean medicine interventions for CPP were retrieved. Results: 11 RCTs were included and total number of experimental group was 390 cases. A total of 4 types of interventions were used, of which acupuncture (45.5%), electro-acupuncture (18.2%), electro-acupuncture + auricular acupuncture + moxibustion (18.2%) were the most frequently utilized. 關元 (CV4) (100.0%), 會陰 (CV1) (80.0%), 三陰交 (SP6) (80.0%), 陰陵泉 (SP9) (80.0%) were most frequently used acupoint in acupuncture treatment. Conclusions: For evidence-based treatment of korean medicine intervention for CPP, high quality RCTs must be conducted.

Comparison of treatment outcomes in chronic coccygodynia patients treated with ganglion impar blockade versus caudal epidural steroid injection: a prospective randomized comparison study

  • Sencan, Savas;Yolcu, Gunay;Bilim, Serhad;Kenis-Coskun, Ozge;Gunduz, Osman Hakan
    • The Korean Journal of Pain
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    • 제35권1호
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    • pp.106-113
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    • 2022
  • Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.

인동소염방(忍冬消炎方)이 만성 비세균성 전립선염 Rat 모델에서 혈액 및 세포조직의 변화에 미치는 영향 (The Effects of IDS(Indongsoyeom-bang) Treatment on the Hematological and Cytopathological Alterations in Non-Bacterial Prostatitis Rat Model)

  • 이종빈;황석연;조충식
    • 혜화의학회지
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    • 제20권1호
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    • pp.91-104
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    • 2011
  • Background : Although chronic non-bacterial prostatitis is increasing, it is hard to treat effectively. In western medicine, antimicrobials drug, ${\alpha}$-adreno-ceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants and anticholinergic agents are used commonly, but chronic prostatitis/chronic pelvic pain syndromes is confusing and frustrating for urologist. IDS(Indongsoyeom-bang) is used in treatment of chronic prostatitis/chronic pelvic pain syndromes. And it is reported that GLS(Gleditsiae spina) and TOF(Toosendan fructus) components of IDS have significant effect on protection of the glandular epithelial cells. Objective : In this study was conducted to investigate the therapeutic effects and action machanism of IDS in the rat model of non-bacterial prostatitis induced by castration and testosterone treatment. Methods : We observed six experimental objects of normal group, control group, testosterone group, and IDS 50 mg/kg, 200mg/kg, 400mg/kg group. Rats were treated with 17 ${\beta}$-estradiol after castration for induction of experimental non-bacterial prostatitis, which is similar to human chronic prostatitis in histophatological profiles. IDS and testosterone were administered as an experimental specimen and a positive control, respectively. The prostates were evaluated by histological parameters including the epithelial score and epithelio-stromal ratio for glandular damage. Also, the prostates were observed by Hematological alterations of WBC, RBC, hemoglobin and platelet. Results : While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with IDS-50 showed a diminished range of the tissue damage. Epithelial score was improved in IDS than that of the control. The epithelio-stromal ratio was lower in IDS when compared to that of the control. Also, the examination of bloods were not observed hematological change. Conclusion : These finding suggests that IDS may protects the glandular epithelial cells. We concluded that IDS could be a useful remedy agent for treating chronic non-bacterial prostatitis.

관절가동술과 깔창적용이 엉치엉덩관절통증환자의 통증과 골반경사각, 족저압에 미치는 효과: 무작위배정예비임상시험 (Effect of Joint Mobilization and Insole on Pain, Pelvic Angle, and Foot Pressure in Patient with Sacroiliac Joint Pain : A Randomized Controlled Pilot Trial)

  • 임재길
    • 한국엔터테인먼트산업학회논문지
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    • 제14권3호
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    • pp.383-392
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    • 2020
  • 이 연구는 엉치엉덩관절 통증환자에게 관절가동술, 깔창착용 보행훈련, 그리고 관절가동술과 깔창착용 보행훈련 중재를 실시하고 환자의 통증, 골반 각 및 족저압에 대한 효과를 비교하였다. 무작위로 24명의 대상자를 관절가동술군(n=8), 깔창착용보행훈련군(n=8) 또는 관절가동술과 깔창착용보행훈련군(n=8)으로 배정하여, 하루에 30분씩, 일주일에 2번씩 4주 동안 중재하였다. VAS를 사용하여 통증을 평가하고 골반 각도를 Palpation Meter 사용하여 측정하였고, 족저압 (전 / 후비)을 Gateview AFA-50을 사용하여 측정하였다. 모든 측정은 중전·중재 4주 후에 실시하였다. 모든 그룹은 그룹 내 전·후 비교에서 유의한 통증 감소를 보였다(p<.01). 골반 각도에서 관절가동술군은 전방 기울기에서만 통계적으로 개선되었고, 관절가동술과 깔창착용 보해훈련군은 앞쪽 및 뒷쪽기울임 모두에서 통계적으로 유의미한 개선을 보였으며(p<.01), 깔창착용 보행훈련군은 통계적으로 유의한 변화가 없었다(p>.05). 또한 관절가동술과 깔창착용 보행훈련군은 족저압에서 유의한 차이를 나타냈다(p<.01). 모든 중재는 엉치엉덩관절 통증환자의 통증개선에 효과가 있었으며, 관절가동술과함께 깔창착용 보행훈련을 한 군이 골반각도와 족저압에 가장 효과적이었다. 이 연구는 엉치엉덩관절통증이 있는 환자뿐만 아니라 만성 허리통증 및 족저압 입력 문제가 있는 환자의 부상 예방, 자세교정, 그리고 보행훈련을 위한 기초자료가 될 것으로 사료된다.

Prevalence and risk factors of low back and pelvic pain in women with rectus abdominis diastasis: a multicenter retrospective cohort study

  • Yuan, Sue;Wang, Honghong;Zhou, Jie
    • The Korean Journal of Pain
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    • 제35권1호
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    • pp.86-96
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    • 2022
  • Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

  • Mitidieri, Andreia;Gurian, Maria Beatriz;Silva, Ana Paula;Tawasha, Kalil;Poli-Neto, Omero;Nogueira, Antonio;Reis, Francisco;Rosa-e-Silva, Julio
    • 대한약침학회지
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    • 제18권4호
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    • pp.26-31
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    • 2015
  • Objectives: This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Methods: Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

요통 환자의 요천추 및 골반 지표 분석 (Analysis of Lumbosacral-Pelvic Parameters in Low Back Pain Patients)

  • 이진현;조동찬;김창곤;문수정;박태용;고연석;이수경;송용선;이정한
    • 한방재활의학과학회지
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    • 제23권2호
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    • pp.139-149
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    • 2013
  • Objectives : The aim of this study was to investigate the characteristic of low back pain(LBP) and lumbosacral-pelvic alignments, and the relationship between them, depending on the presence and the duration of LBP. Methods : Ninety six patients were classified into the no LBP group(n=31), the acute LBP group(n=33) and the chronic LBP group(n=32), based on the presence and duration of LBP. In each group, lumbosacral-pelvic indicators were measured. The data were analysed by one way analysis of variance(ANOVA) and pearson correlation. Results : 1. The chronic LBP group showed the lower mean value in Ferguson angle, Lumbar lordosis angle, Pelvic Incidence and difference between left and right iliac height, being compared to acute LBP group. 2. There was not significant correlation between lumbosacral-pelvic alignments and LBP in every group. 3. A positive correlation was found among period of LBP and visual analogue scale(VAS), Oswestry disability index(ODI). Conclusions : For presence and duration of LBP, there were different characteristic values in descriptive statistics. And period of LBP is the most important factor for the degree of LBP. These results show that the lumbosacral-pelvic alignments and LBP have distinctive relationships depending on the duration of LBP.

이상근 증후군 치험 1례 (A Case Report of the Piriformis Syndrome Treated by Caudal Steroid and Local Anesthetic)

  • 정창영;윤명하;임웅모;김별아
    • The Korean Journal of Pain
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    • 제8권1호
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    • pp.149-151
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    • 1995
  • Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

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