• Title/Summary/Keyword: Chronic Low Back

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Foot Pressure Analysis of Chronic Low Back Pain Patients by Foot Analyzer (Foot analyzer를 이용한 만성 요통 환자들의 족저 압력 분석)

  • Kim, Eun-Joo;Cho, Yu-Jeong;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.115-126
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    • 2009
  • Objectives : The aim of this study was to evaluate whether the foot pressure distribution correlates with the lumbo-sacral curvature, and the Oswestry Disability Index in chronic low back pain patients. Methods : We measured the fore foot pressure and the rare foot pressure using the foot analyzer in 28 women subjects with chronic low back pain. The lumbo-sacral curvature and the Oswestry Disability Index(ODI) were also measured. Results : 1. Subjects with higher ODI(%) had significantly lower Fore foot pressure/Rare foot pressure ratio(F/R ratio) (p<0.01). 2. Lumbar lordotic angle and Ferguson angle were inversely related to ODI(%) (p<0.05, p<0.01). 3. Lumbar lordotic angle and Ferguson angle were positively related to F/R ratio (all p<0.05). Conclusions : Using the Foot Analyzer(FA-48S, Tech storm Inc.) we have shown that F/R ratio has significant correlation with the lumbo-sacral curvature and the Oswestry Disability Index. These result suggest that the Foot analyzer may be used in assessing back pain in chronic low back pain patients.

Diagnosis and Management of Low Back Pain (요통의 진단과 치료)

  • Jang, Jae Hong;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.1-6
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    • 2012
  • Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

Degrees of Low Back Pain, Knowledge of and Educational Needs for Low Back Pain in Patients with Chronic Low Back Pain (만성 요통 환자의 통증, 지식 및 교육 요구)

  • Kim, Seong Kyong;Kim, Hee Seung;Chung, Sung Soo
    • Journal of muscle and joint health
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    • v.24 no.1
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    • pp.56-65
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    • 2017
  • Purpose: The purposes of this study were to identify degrees of low back pain, knowledge of and educational needs for low back pain of patients with chronic low back pain and to investigate their relationships. Methods: Data were collected from questionnaires distributed to 83 patients with chronic low back pain at a hospital. Results: The low back pain score was $4.70{\pm}2.22$ out of 10. The degree of low back pain was a statistically significant difference according to gender, smoking, radiating pain and frequency and duration, daily life disturbance degree, sleep disturbance and depression. The knowledge score was 8.29 out of 13. The knowledge was a statistically significant difference according to smoking and degree of sleep disturbance. The educational needs score was 39.83 out of 50. The educational needs was a statistically significant difference according to age, duration of disease, radiating pain, standing time, depression, pain treatment experience, and treatment institutions. As the low back pain increased, the educational needs increased (r=.254, p=.021). There were no correlations between low back pain and knowledge (r=-.040, p=.720) and knowledge and educational needs (r=.061, p=.581). Conclusion: It is important to focus on items with statistically significant differences in pain, knowledge, and educational needs, and to select low knowledge and high educational needs items to develop a systematic education plan.

The Effect of the Core Stabilization Exercise and Thoracic Manipulation on the Respiratory Function of Chronic Low Back Pain Patients (척추 안정화 운동과 등뼈 가동성 운동이 만성 허리 통증 환자의 호흡 기능에 미치는 영향)

  • Park, Sunja;Kim, Youngmi;Han, Jiwon
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.3
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    • pp.43-52
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    • 2020
  • Purpose : The aim of this study was to investigate the change of the respiratory function of chronic low back pain patients after the thoracic manipulation and the trunk stability exercise on chronic low back pain patients. Methods : For this study, the group of the experiment was consisted of 44 patients suffering from the low back pain chronically. The participants were divided into two groups: the control group, which was assigned for core stabilization exercise (CSE), and the experimental group, which was randomly assigned for core stabilization exercise after thoracic manipulation (CSE+TM). Both groups carried out each assigned treatment on three times a week for 8 weeks. To study the change related to measurement variable from each test groups before and after intervention, paired t-test was performed. Further, the statistics for an intergroup comparison was analyzed by covariance analysis, ANCOVA. The measurement was conducted by the respiratory function, the respiratory function was measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Results : As a result, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) showed significant differences not only by each groups but also between those groups before and after the test. Conclusion : In conclusion, both experiments, the core stabilization exercise and the core stabilization exercise conducted after thoracic manipulation, on chronic low back pain patients resulted in the significant level of difference in the respiratory function. This result indicates that the thoracic manipulation is an efficient treatment for improving the respiratory function for chronic low back pain patients.

The Effect of Sling Exercise and Conservative Treatment on Cross-section Area Change of Lumbar Muscles (슬링 운동과 보존적 치료가 요부근육의 횡단면적 변화에 미치는 영향)

  • Lee, Woo-Hyung;Jeong, Seong-Gwan;Park, Rae-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.2
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    • pp.233-243
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    • 2010
  • Purpose : This study aimed to examine the effects of sling exercise therapy on the relief of low back pain and the cross-sectional area change of lumbar muscles by CT analysis for chronic low back pain patients. Methods : Forty-one patients with diagnosis of chronic low back pain was divided sling exercise therapy group(SEG) 19 subjects and conservative physical therapy group(CPG) 22 subjects. we randomized and treated them(subjects) for 12 weeks. As using visual analogue scale(VAS), we evaluated recovery accuracy of pain, and for investigating cross-section area change of lumbar muscles for before and after treatment we used computed tomography(CT). Results : This study were summarized as follows : 1) As treatment period, in each compared testing on VAS of SEG and CPG, the both group was significantly different(p<.05). 2) Compared testing on VAS of between-subject groups(SEG and CPG) were not significantly different(p>.05). 3) At SEG of before and after treatment, in compared testing on cross-section area size of lumbar muscles, All muscles of psoas major, quadratus lumborum, erector spinae and multifidus were significantly different(p<.05). At CPG, psoas major was significantly different(p<.05). But other muscles were not significantly different(p>.05). Conclusion : From this result, both sling exercise therapy and the conservative physical therapy are effect on decrease of pain for chronic low back pain patients. but Increasing of the cross-section area being proportioned with muscular strengthening of low back muscle is noticeable difference in SEG. Therefore, sling exercise therapy have affect both decreasing of pain for chronic low back pain patients and lumbar muscles strengthening.

Repetitive Transcranial Magnetic Stimulation to Treat Depression and Insomnia with Chronic Low Back Pain

  • Park, Eun Jung;Lee, Se Jin;Koh, Do Yle;Han, Yoo Mi
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.285-289
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    • 2014
  • Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

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.

Comparison of Multifidus Thickness Change During Contralateral Arm Lift(CAL) in Patients with Chronic Low Back Pain and Normal Adults (반대쪽 팔 들기 동작 시 만성요통환자와 정상인의 다열근 두께 변화 비교)

  • Song, Won-bin;Kim, Chi-hyok;Jung, Woong-keun;Ha, Ye-ji;Han, Seong-gu;Hwangbo, In
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.51-58
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    • 2018
  • Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

A Study on the Relationship Between the Results of Shortening of the Iliopsoas Muscles and the Lumbar Instability Tests in Patients with Chronic Low Back Pain (만성 허리통증 환자의 엉덩허리근 단축과 허리 불안정성 검사 간에 관련성 연구)

  • Chang-Hyun You;Suhn-Yeop Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.2
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    • pp.49-59
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    • 2023
  • PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

Effects of Pain Neuroscience Education on Pain, Body Function, Activity Disorders, and Depression in Patients with Chronic low back Pain: Randomized Controlled Trail

  • Kyoung-Gon Oh;Min-Ji Lee;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.1-14
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    • 2024
  • Background: Many patients with chronic low back pain have reduced movement due to pain. For that reason, muscle strength weakens, which leads to pain again. The pain caused by such a vicious circle is not only caused by structural problems, but also by physical function, activity disorder, or psychological depression due to biopsychosocial approaches and pain neuroscience education was applied as an intervention to find out its effect. Therefore, this study was experimented with to find out the effects of pain neuroscience education on pain, physical function, activity disorder, and depression in patients with chronic low back pain. Design: Randomized control trial Method: The study subjects were 39 patients with chronic low back pain, and the study subjects were randomized through computers to the experimental group applying pain neuroscience education and the control group applying only general physical therapy and myofascial release techniques, and the experiment was conducted for 4 weeks. Pressure Pain Threshold , Schober test, Korean Roland-Morris Disability Questionnaire, Korean Oswestry Disability Index, and Korean Depression Screening Assessment were measured. Results: As a result of the study, there was no significant difference in pain neuroscience education compared to the group that applied only general physical therapy and myofascial release techniques in both lumbar pressure pain thresholds, Schober test, Korean Roland-Morris disability questionnaire, and Korean Oswestry disability questionnaire. However, the Korean Depression Screening Assessment which is the result of measuring depression, showed significant results(p<0.05). Conclusion: Therefore, it is believed that it can be a way to mediate the psychological part through pain neuroscience education for patients with chronic low back pain in the future.