• Title/Summary/Keyword: Joint pain

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Value of Bone Scintigraphy and Single Photon Emission Computed Tomography (SPECT) in Lumbar Facet Disease and Prediction of Short-term Outcome of Ultrasound Guided Medial Branch Block with Bone SPECT

  • Koh, Won-Uk;Kim, Sung-Hoon;Hwang, Bo-Young;Choi, Woo-Jong;Song, Jun-Gul;Suh, Jeong-Hun;Leem, Jeong-Gill;Shin, Jin-Woo
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.81-86
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    • 2011
  • Background: Facet joint disease plays a major role in axial low-back pain. Few diagnostic tests and imaging methods for identifying this condition exist. Single photon emission computed tomography (SPECT) is reported that it has a high sensitivity and specificity in diagnosing facet disease. We prospectively evaluated the use of bone scintigraphy with SPECT for the identification of patients with low back pain who would benefit from medial branch block. Methods: SPECT was performed on 33 patients clinically suspected of facet joint disease. After SPECT, an ultrasound guided medial branch block was performed on all patients. On 28 SPECT-positive patients, medial branch block was performed based on the SPECT findings. On 5 negative patients, medial branch block was performed based on clinical findings. For one month, we evaluated the patients using the visual analogue scale (VAS) and Oswestry disability index. SigmaStat and paired t-tests were used to analyze patient data and compare results. Results: Of the 33 patients, the ones who showed more than 50% reduction in VAS score were assigned 'responders'. SPECT positive patients showed a better response to medial branch blocks than negative patients, but no changes in the Oswestry disability index were seen. Conclusions: SPECT is a sensitive tool for the identification of facet joint disease and predicting the response to medial branch block.

Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

A Study of Family Support, Pain, Self-esteem, ADL in Patients with Ankylosing Spondylitis (강직성 척추염환자의 가족지지, 통증, 자아존중감, 일상생활 활동에 관한 연구)

  • Kim, Kyoung-Sug;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.12 no.1
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    • pp.7-15
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    • 2005
  • Purpose: The purpose of this study was performed to understanding of family support, pain and self-esteem, activities of daily living(ADL) in patient with ankylosing spondylitis(AS) and to identify the relationship among variables. Method: This study was conducted on 55 adults diagnosed with AS in C hospital in Daejeon during January 15th to June 20th, 2004. Instruments in this study were pain scale (VAS), family support scale, self-esteem scale, ADL scale. The data were analyzed mean, standard deviation, one-way ANOVA, Pearson's Correlation Coefficient using SPSS WIN(ver 10.0) program. Results: 1) 83.6% of the subjects was men, 30.9% of the subjects' age was below 29. And the 90.9% of the subjects was no experience of education about AS, 41.8% of the subjects was doing exercise. 2) The pain score was 48.36, family support score was 3.98, self-esteem score was 3.52 and ADL score was 81.41. 3) Family support was positively correlated with self-esteem and ADL and negatively correlated with pain. self-esteem was negatively correlated with pain and ADL. Conclusion: The results in this study can help nurse who care patients with AS understanding the relationships among family support, self-esteem, ADL, pain. And this findings showed that the patients with AS have few experience for disease-related education to manage and to understand AS. Therefore disease-related educational nursing program based on family support, pain, ADL of AS is needed to understand and manage AS. Because family support, pain, ADL of AS were significant correlated.

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Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis

  • Mena, Mariam;Dalbah, Lana;Levi, Lauren;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.337-356
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    • 2020
  • This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

Immediate Effects of Cervical and Thoracic Mobilization on Cervical Range of Motion in the Sagittal Plane and Pain in Patients with Forward Head Posture

  • Choi, Won-Jae;Kang, Si-Nae;Lee, Seung-Won
    • PNF and Movement
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    • v.20 no.3
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    • pp.371-381
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    • 2022
  • Purpose: Forward head posture (FHP) is known to cause pain, limit range of motion, and reduce quality of life. Joint mobilization is commonly used to correct FHP. However, no study has compared cervical, thoracic, and combined cervical and thoracic joint mobilization for FHP. The aim of this study was to investigate and compare the effects of each mobilization technique on range of motion in the sagittal plane and pain in patients with FHP. Methods: Forty-five patients were recruited and randomly divided into three groups: the mobilization group (CM; n = 15), the cervical and thoracic mobilization group (CTM; n = 15), and the thoracic mobilization group (TM; n = 15). Each intervention was performed in sets of three and repeated six times. Range of motion and pain were assessed pre- and post-intervention. The cervical range of motion was evaluated using a goniometer, and pain was evaluated using a visual analogue scale and pain thresholds of the suboccipital and upper trapezius muscles. Results: All groups showed an increase in range of motion post-intervention, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Pain measured using the visual analogue scale decreased in all groups, but the decreases in the CM and CTM groups were significantly greater than in the TM group (p < 0.05). The pain thresholds of the suboccipital and upper trapezius muscles increased in all groups, but the increase in the CTM group was significantly greater than in the CM and TM groups (p < 0.05). Conclusion: Overall, our findings suggest that CTM may be more effective than CM or TM for improving cervical range of motion in the sagittal plane and pain in patients with FHP.

Utility of Bone SPECT in Temporomandibular Joint Pain (악관절 동통 환자에서 Bone SPECT의 유용성)

  • Yang, Dong-Hunn;Sung, Mi-Sook;Lee, Jung-Whee;Chung, Soo-Kyo;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.388-394
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    • 1997
  • Temporomandibular (TM) joint Pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

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Relationship between Joint Space and Craniofacial Morphology in Patients with Craniomandibular Disorders (두개하악장애환자에서 악관절강폭과 측모두부형태와의 관계에 관한 연구)

  • Myung-Seok Seo;Kyung-Soo Han;Min Shin
    • Journal of Oral Medicine and Pain
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    • v.17 no.2
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    • pp.63-73
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    • 1992
  • This study was performed for the purpose of investigating the relation between width of temporomandibular joint space and craniofacial morphology in patients with CMDs. The subjects utilized here were aged from 16 to 63 years old and 19 male and 46 female. For the study, each patient was taken radiographs by Transcranial and Lateral Cephalographic projection and the films were traced with routine method. The measured items were anterior, superior, posterior joint space and relative condylar position to the deepest part of glenoid fossa in Transcranial film and items related vertical and/or horizontal growth in Cephalogram. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows : 1. Anterior joint space in affected side were wider than that of unaffected side, but for superior and posterior joint space, the value of unaffected side were more than those of affected side. 2. Superior or posterior joint space of affected side were significantly correlated with items related vertical growth, such as ramus height, Jarabak ratio, FMA. From this, the following cold be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed growth pattern of counter clockwise. 3. Superior or posterior joint space of affected side were significantly correlated with items related horizontal growth, such as SNPo, NAPo, APDI and ANB. From this the following could be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed anterior displacement of mandible. 4. It would be proposed that the diagnositic value of superior and posterior joint space of affected side in transcranial radiograph was excellent.

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Effects of Tibiofibular Joint Mobilization on Range of Motion, Balance, and Pain in Patients with Lateral Ankle Sprain (정강종아리 관절가동술이 외측 발목염좌 환자의 통증, 관절가동범위 및 균형에 미치는 영향)

  • Eui-young Jeong;Si-hyun Park
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.30 no.1
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    • pp.51-60
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    • 2024
  • Background: Ankle sprains are a common clinical ankle disorder and alternations in tibiofibular joint biomechanics along with the talus are thought to contribute to its occurrence. During ankle joint dorsi flexion, proper movement requires the talus to glide posteriorly. Due to the wider front of the talus head, achieving the end range of dorsi flexion necessitates both superior and posterior glide of the distal fibula and anterior glide of the proximal fibula. The purpose of this study was to investigate the effects of tibiofibular joint mobilization on pain, range of motion, and balance in patients with lateral ankle sprains. Methods: Participants were randomly assigned to a control group (n=33) or an experimental group (n=31). Both groups underwent ankle joint mobilization three times a week for two weeks. Additionally, the experimental group received proximal and distal tibiofibular joint mobilization three times a week for two weeks. Measurements were obtained pre-intervention and post-intervention (after 2 weeks). Results: Evaluation parameters included the visual analog scale score (VAS), range of motion (ROM), and one-leg standing test (OLS). Post-intervention, both groups demonstrated significantly improved results for all assessments (p<.01). A significant intergroup difference was observed only in the ROM (p<.01) and OLS (p<.05). Conclusion: Our findings suggest that tibiofibular joint mobilization, combined with ankle joint mobilization, may be beneficial in enhancing outcomes for individuals with lateral ankle sprains.

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Comparison of Tension Type Headache Associated with Pericranial Tenderness and Headache Attributed to Temporomandibular Joint Disorder Using RDC/TMD Axis II (두개주변압통과 관련된 긴장성 두통과 측두하악장애에 기인한 두통과의 RDC/TMD Axis II에 따른 비교)

  • Park, Hyung-Yun;Bae, Sung-Jae;Yoo, Sang-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.123-133
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    • 2010
  • The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

Effects of Aquatic Exercise Program on Pain, Flexibility, Grip Strength, Self-Care Activities and Helplessness in Patients having Osteoarthritis (수중운동 프로그램 참여 후 골관절염 환자의 통증과 자기간호활동, 유연성, 악력 및 무력감의 변화)

  • Kim, Young-Jae;Kim, Chang-Sook;Park, In-Hyae
    • Journal of muscle and joint health
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    • v.11 no.2
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    • pp.127-135
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    • 2004
  • Purpose: The purpose of this study was to explore the effects of aquatic exercise program on pain, flexibility, grip strength, self-care activities, helplessness in osteoarthritis patients. Methods: This program was carried out three times a week for 6 weeks by 3 groups of patients among 42 patients in regular swimming pool. Data were analysed by paired t-test for pre and post comparison. Results: There were significantly improved in pain flexibility, grip strength, self-care activities and helplessness after the program. However no significant differences were found in fatigue, difficulty of daily living activities and depression. Conclusion: Aquatic program was proved to be an effective nursing intervention to increase the self-care activities flexibility and grip strength, and to decrease pain and helplessness in osteoarthritis patients.

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