• Title/Summary/Keyword: Chronic low-back pain patient

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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.

Lumbar Combined Rehabilitation Exercise for Lumbar Reposition Sense, Static Balance and Pain of the Patient's with Chronic Low Back Pain (만성요통환자의 복합재활운동이 통증과 정적균형, 재위치감각인지에 미치는 영향)

  • Kim, Deahun
    • Journal of Convergence for Information Technology
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    • v.9 no.11
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    • pp.196-201
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    • 2019
  • The purpose of this study is to identify the effects of the apply of lumbar stabilization exercises and lumbar strengthening exercises using Medx machine on back functions such as static balance, lumbar reposition sense, and back pain(VAS) in chronic low back pain. This study divided 30 chronic low back pain patients who experienced only lumbar back pain(male: 5, female: 10) into a lumbar stabilization exercise group and a complex exercise group, and then performed their respective exercise programs for three times a week over a 8-week period. The lumbar static balance, lumbar reposition sense, and lumbar back pain were measured using a pair t-test within each group, and were also compared between two groups using an independent t-test. The results of the present study were as follows: Both groups exhibited statisti cally significant increases after performing their own exercise program in the static balance, lumbar reposition sense, and lumbar back pain(p<.05). However, the comparison of two groups confirmed that the complex exercise group resulted in greater effects than the lumbar stabilization exercise group(p<.05). In conclusion, muscle strengthening and stabilization exercises in chronic low back pain patients are considered to not only relieve back pain, but also improve various back functions.

Intradiscal Electrothermotherapy(IDET) in Patients with Chronic Discogenic Low Back Pain ; Preliminary Report (만성 추간판인성 요통 환자에서 추간판내 열 치료법의 치료효과 ; 예비보고)

  • Ryu, Kyung Sik;Park, Chun Kun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.749-754
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    • 2001
  • Objective : The IDET(Intradiscal electrothermal therapy) appears as a new therapeutic modality for intractable discogenic back pain. We carried out a prospective study to analyze and evaluate the therapeutic effects of IDET. Methods & Results : During a six month period, we performed IDET in 39 patients with chronic low back pain using RITA Model 30 Electrosurgical device. The patients included 21 men and 18 women. The mean patient age was 50.2 years(range 21-73 years). All patients underwent preoperative plain radiography and MRI for excluding non-discogenic back pain. We conducted discography-CT to reveal painful discs in all patients. During the study, we measured intradiscal pressure subjectively. The area of annular tear, which identified with post-discography CT scan, was coagulated in $90^{\circ}C$ of temperature for 15 minutes. Of the 17 patients who were followed up more than three months after surgery, the 10 patients(58.8%) experienced clinical improvement. Three patients had high intradiscal pressure on discography, other three patients had loss of disc height more than 30% of normal on plain radiography, and one patient suffered from postoperative epidural abscess. All of these patients were included in the remaining no improvement group(41.2%). Conclusion : The IDET procedure could be an alternative modality for discogenic back pain. It appears that a patient who has low intradiscal pressure on discography and intact disc height on plain radiography is considered a good candidate for IDET.

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Effect of the Electro-acupuncture Stimulation into the Multifidus on Subjective Pain and Lumbar Flexibility in Patients with Chronic Low Back Pain (만성요통 환자의 다열근에 적용한 전침이 통증 및 유연성에 미치는 효과)

  • Jang, Won-Seok;Park, Hung-Ki;Kim, Keun-Joo
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.3
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    • pp.185-192
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    • 2008
  • Purpose : The purpose of this study is to examine the effect of the electro-acupuncture stimulation into the multifidus for the lumbar flexibility improvement and pain reduction. The subjects were consisted of 20 women patients with chronic low back pain. Methods : 20 women patients with chronic low back pain voluntary participated for the research. 15 minute electro-acupuncture stimulation(frequency: 4Hz, Intensity: below threshold of pain) with Infra-red therapy, 3 times a week during 6 weeks period. Acupuncture application given to the patients' trigger point of the multifidus. The Application of multifidus was L3, L4, L5 spinal vertebra levels Short form McGill pain questionnaire (SFMPQ) was used to measure patient's pain level. Lumbar flexibility measurement was trunk flexion and trunk extension. Global Perceived Effect Scale(GPES) was used to measure recovery or worse of patient's condition. Results : SFMPQ was after treatment showed significantly decreased more than before stimulation treatment (P<.05). Lumbar flexibility was after treatment showed significantly increase more than before treatment(P<.05). GPES was after treatment showed significantly increased more than before treatment(p<.05). Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. So chronic LBP patients necessary multifidus muscle release treatment.

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Change of Lumbar Multifidus Muslce Recorded Simultaneously by Ultrasound Imaging during Upper Extremity Lifting Movement in Chronic Low Back Pain Patients (만성 요통 환자의 상지 기능적 동작시 초음파에 나타나는 다열근의 변화)

  • Jang, Won-Seok
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.1
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    • pp.9-14
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    • 2009
  • Purpose : The purpose of this study is change of lumbar multifidus muslce recorded simultaneously by ultrasound imaging during upper extremity functional movement in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. Multifidus size were measured from L4 vertebral segement. The ultrasound imaging apparatus(Sonoace 6000, Medison, Korea) was epuipped with a 5-MHz convex array transducer. The upper extremity lifting movement used to activate the multifidus was then measured. Results : Results of the analysis showed that at the L4 vertebral leves, healthy asymptomatic subjects had significantly larger multifidus muscle compared with chronic LBP subjects. Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Especially multifidus contraction in L4 vertebral segement. So chronic LBP patients necessary multifidus muscle release treatment.

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The Relationship between Perceived Family Functioning and Depression in Patients with Chronic Low-Back Pain (만성요통환자가 지각하는 가족기능과 우울의 관계)

  • Son Jung-Tae;Park Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.316-331
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    • 2000
  • This study was conducted using a descriptive correlational survey design to identify how patients with chronic low-back pain perceived family function and to examine the relationship between family function and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-up treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were FACE II-Korean version and Beck's Depression Inventory(1983). The data collected were analysed using mean, standard deviation(SD), t-test, F-test, Duncan test and Pearson correlation coefficient, done with SAS. The results are as follows; 1. The mean of the respondents' perceived family function was 3.47, with emotional bonding at 3.61, acceptability and sharing at 3.61, participation at 3.23, negotiation and satisfaction at 3.24 and responsibility and expectation at 3.76. 2. The mean of the respondents' perceived depression was $17.53{\pm}8.76$. 3. There was significantly negative correlation between family function and depression(r=-0.4817, p=.0001). 4. Research variables included demographic characteristics and showed that subjects who were aged 65 years or older showed significantly lower scores in patient's perceived family function than those who were aged 45 years or below(p=.0502). Perceived family function of females respondents were significantly lower than males(p=.0026). The illiterate showed significantly lower scores than other groups(p=.0001). Respondents with spouse and extended family tended to show significantly higher scores than those who were living with spouse only or by themselves alone(p=.0091). Those who had higher income showed significantly higher scores than in the lower income group(p=.0001). 5. For family function regarding pain characteristics, those who reported severe pain-related daily activity impediments showed significantly lower scores in family function than others with less pain(p=.0357).

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Discitis after Intradiscal Radiofrequency Thermocoagulation in Patient with Chronic Discogenic Low Back Pain -A case report- (만성 추간판성 요통(discogenic lumbago) 환자에게 Intradiscal Radiofrequency Thermocoagulation을 시행한 후 발생한 추간판염 -증례 보고-)

  • Park, Jun-Soon;Kim, Jong-Il;Lee, Sang-Gon;Ban, Jong-Seuk;Min, Byoung-Woo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.162-167
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    • 1999
  • We have observed discitis developed after Intradiscal radiofrequency thermocoagulation in a patient with chronic discogenic low back pain. Recently, it is becoming more common that pain-managers perform disc-manipulation or, a nerve block after penetrating a disc, so postprocedural infection of disc can be a problem. To prevent discitis, very carefull attention must be given to ensure aseptic conditions during this procedure. However, if it occurs, it needs to be treated properly. In this case, a good result was obtained by treatment with absolute bed rest, pain management, and antibiotics.

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The effect of muscle strength, endurance and flexibility on Graded Low back exercise and education of chronic low back pain patents. (만성요통환자의 점증적 요통 운동과 교육이 근력과 근지구력, 유연성에 미치는 효과)

  • Han, Sang-Wan;Kong, Sung-Ah;Lee, Jun-Hee
    • Journal of Korean Physical Therapy Science
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    • v.9 no.2
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    • pp.27-36
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    • 2002
  • The purpose of this study was to examine the effects of graded low back exercise program with patient education about low back pain care on abdominal strength, endurance and flexibility of waist of chronic low back pain patents. For this study 13 patients aged 40 to 60 were selected as subjects, who suffered from low back pain and got diagnosed by physician. The exercise program and the education were executed for total 6 weeks, posture education were executed with physical exercises over first 1 to 4 weeks period and over 5 to 6 weeks the exercises were executed. The effect of the exercises and the education were evaluated through weights, WHR, fat(%), flexibility by sit-and-reach and trunk extension test, strength by sit-up test and back sit-up test. Weights were, decreased after physical exercise and education, but there was no statistical significance. Wasit hip ratio(WHR) and fat(%) were decreased after physical exercise and education, but there were no statistical significances. Sit-and-reach was significantly increased from $13.68{\pm}5.59cm$ to $19.45{\pm}3.81cm$ after education and physical exercise(P<0.05). Trunk extension was significantly increased from $30.31{\pm}11.34cm$ to $40.88{\pm}6.16cm$ after education and physical exercise(P<0.05). Sit-up and Back sit-up were increased after physical exercise and education, but there were no statistical significances. These results suggest that graded low back exercise program with patient education about low back pain care increase the abdominal strength, endurance and the flexibility of waist in low back pain patients.

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Comparison of Ranges of Motion in The Thoracolumbar Region for Clinical Diagnoses of Patients with Chronic Low Back Pain (만성요통 환자의 질환명에 따른 흉요추부의 관절가동범위 비교)

  • Lee, Sang-Wook;Kim, Suhn-Yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.363-373
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    • 2010
  • Purpose : The purpose of this study was to compare differences in thoracolumbar ranges of motions by comparing ratios among 4 type diagnosis for patient with chronic low back pain. Methods : The subjects were 58 chronic low back pain patients. A motion analysis program (Global Postural System) was used after photography for posture measurement. To analyze differences in mobility percentages and ratios of thoracolumbar ranges of motion, one-way ANOVA was used. Results : Regional difference spinal posture and movement were found to diagnosis patients with chronic low back pain. Comparison of thoracolumbar ranges of motion revealed significant differences in the thoracic region during forward-bending of the trunk (p<.05). In the upper thoracic region, the herniated intervertebral lumbar disc (HILD) group was significantly larger than the spinal stenosis/herniated intervertebral lumbar disc (SS/HILD) group (p<.05). In the lower thoracic region, chronic sprains (CS) were significantly greater than in the spinal stenosis (SS) group and in the (SS/HJLD) group (p<.05). Comparative analysis of thoracic/lumbar mobility ratio showed the CS group's ratio during forward bending was largest: 1.66, while the HILD group's ratio was smallest: 84 a significant difference between the two groups (p<.01). Diagnosis was not associated with difference in thoracolumbar backward-bending range of motion (p>.05). Conclusion : Theses results indicate the clinical efficacy of diagnosing for chronic low back pain by evaluating spinal mobility.

Case Study of Application on ADIM of Patient With Chronic Low Back Pain for Contraction Training of Transversus Abdominis (만성요통환자의 복횡근 수축훈련을 위한 ADIM 적용사례)

  • Kim, Han-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.49-55
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    • 2011
  • Background: The purpose of this study was to identify the effects of the abdominal drawing-in maneuver (ADIM) for contraction training of transversus abdominis (TrA) to the patient with chronic low back pain (CLBP). Methods: A 37-year female patient with CLBP participated in study. This study was fix to method of ADIM that maintain to draw in lower abdomen in sitting position on chair and fix 1 time protocol that perform rest for 1-min and ADIM for 1-min during 10-min. Hereunder the subject performed 2 times protocol during 30-min. Measurement method were visual analogue scale (VAS), Korean version of Oswestry disability index (KODI) and using ultrasound imaging. Results: VAS was decreased 5cm to 1cm after intervention 3 weeks, KODI was decreased 22% to 9% after intervention 3 weeks and changes in thickness of the TrA were increased 32% to 68% during ADIM. Conclusions: These findings suggest that performed the ADIM took effect for decreased pain and functional disability level with increased changes in thickness of the TrA. Therefore, patients with CLBP should be use for training of deep abdominal muscles apply to the ADIM.

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