• Title/Summary/Keyword: Upper back pain

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Nineth Rib Syndrome after 10th Rib Resection

  • Yu, Hyun Jeong;Jeong, Yu Sub;Lee, Dong Hoon;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.185-188
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    • 2016
  • The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.

A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient (폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.372-377
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    • 2007
  • Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

Lumbar stabilization exercises using the sling system (슬링(sling) 시스템을 이용한 요부 안정화 운동)

  • Kim, Suhn-Yeop;Kwon, Jae-Hoak
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.2
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    • pp.23-39
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    • 2001
  • Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

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Analysis about Deviation of Upper Cervical of Patients with Whiplash injuries (교통사고로 인한 편타손상환자의 상부경추분석을 통한 고찰)

  • Lee, Kyung-yun;Park, Min-jung;Cho, Won-young;Park, Koae-hwan
    • Journal of Acupuncture Research
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    • v.20 no.6
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    • pp.27-35
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    • 2003
  • Objective: We intended to show the relation between whiplash injury and deviation of upper cervical through analysing patients having deviation of upper cervical injuried by whiplash. Methods: We chose 40 patients who have been admitted for whiplash injury syndrome in vertebral-joint center of Conmaul oriental medical hospital during 2001.10.1-2003.10.15. We examined cervical simple X-ray of them according to the traffic accident patterns and the position in the veicle. Results: The 97% of the cases showed AS deviation and the 95% of them complained neck pain. The first cases collided from the back on the driving seat showed AS deviation. The second cases collided from the front on the back seat showed AS deviation of left lateral misalignment of atlas. The third cases collided from the front on the assistant seat showed AS deviation of right lateral misalignment of atlas.

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Status and Characteristics of Occurrence of Work-related Musculoskeletal Disorders (직업성 근골격계질환의 발생 현황과 특성)

  • Kim, Kyoo-Sang;Park, Jung-Keun;Kim, Day-Sung
    • Journal of the Ergonomics Society of Korea
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    • v.29 no.4
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    • pp.405-422
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    • 2010
  • Occupational musculoskeletal disorders currently account for the largest proportion of the occupational illnesses in Korea. In this research, status of musculoskeletal disorders among the occupational illnesses was examined through workers' compensation claims data. Types and characteristics of musculoskeletal disorders were looked at other data set as well. The data sets included epidemiological investigation data reported by Occupational Safety and Health Research Institute, and data collected from occupational disease surveillance reports and Korean occupational health-related scientific journals. Number of cases, incidence rate and insurance benefits for occupational musculoskeletal disorders in Korea are increasing every year. In addition, musculoskeletal disorders occurrence is shifted from large enterprises group to small-and-medium group, from manufacturing to service sector, and from production workers to office and professional workers. Although low back pain is still most common, its occurrence characteristics is gradually shifted from traumatic to cumulative while musculoskeletal disorders are somewhat seemingly moved from lumbar to upper limb body part. Musculoskeletal disorders were observed to be more diverse and prevalent in epidemiological investigations or surveillance data rather in workers' compensation claims data. Musculoskeletal disorders occurrence is related to demographic factors, occupational psychosocial factors, and ergonomic risk factors at workplace for which appropriate preventive measures needed to be made accordingly.

Treatment of Primary Fibromyalgia Syndrome Patient -A case report- (Primary Fibromyalgia Syndrome 환자의 치험례 -증례 보고-)

  • Heo, Hoo-Man;Park, Sang-Min;Kim, Yong-Ik;Park, Wook
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.138-142
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    • 1998
  • Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

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Changes in Physiological Characteristics of Trapezius, Multifidus and Hamstring Muscles According to Tilt Angle of Exercise Bed in Elderly (운동침대 틸트 각도 변화에 따른 노인의 승모근, 다열근 및 슬괵근 근육의 생리학적 특성 변화 연속 증례 연구)

  • Kim, Jungjin
    • Archives of Orthopedic and Sports Physical Therapy
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    • v.14 no.2
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    • pp.127-133
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    • 2018
  • Purpose: This study investigated the effects of changing the tilt angle of the exercise bed on physiological characteristics of trapezius, multifidus, and hamstring muscle function. Methods: Twenty elderly who complains of back and lumbar pain or discomfort participated in this study (average age: $64.70{\pm}4.55$ years). The physiological characteristics, including muscle tone (F), dynamic stiffness (S), and elasticity (D) of trapezius, multifidus, and hamstring muscles were measured by a Myoton device at three tilt angles (0, 15, and 30 degrees) during exercise. Results: The muscle tone, dynamic stiffness, and elasticity of the right trapezius and left hamstring muscle showed significant differences (p<0.05) according to exercise bed tilt angle, while the other muscles showed no significant differences. Conclusions: Our results demonstrate that physiological characteristics of the upper and lower extremity muscles are affected ipsilaterally, according to the tilt angles of the exercise bed.

Effect of Posterior-Anterior Mobilization of the Thoracic Spine on Pain, Respiratory Function, and Thoracic Circumference in Patients With Chronic Low Back Pain

  • Park, Ju-jung;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.25 no.4
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    • pp.37-45
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    • 2018
  • Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

The Effect of Korean Medical Treatment with Postural Yinyang Correction of Temporomandibular Joint on Chronic Low Back Pain (턱관절 자세 음양 교정술을 병행한 한방치료가 만성요통에 미치는 영향)

  • Kim, Shin Young;Seo, Jong Cheol;Seo, Yeon Ju;Park, Jong Hyeon;Lee, Yoon Joo;Kim, Cheol Hong;Song, Chun Ho;Jang, Kyung Jeon;Lee, Young Jun;Yoon, Hyun Min
    • Korean Journal of Acupuncture
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    • v.33 no.4
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    • pp.157-165
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    • 2016
  • Objectives : The purpose of this study was to examine whether or not Postural Yinyang Correction of TMJ(Temporomandibular joint) using Standard intraoral appliance could decrease chronic low back pain. Methods : We reviewed the medical records of 40 patients with TMJ disorder aged from 30 to 70 years from 124 patients who were treated in chronic low back pain at Department of Acupuncture & Moxibustion of Korean Medicine Hospital of Dong-Eui University from November $1^{st}$, 2015 to June $5^{th}$, 2016. The patients were divided into 2 groups: Group A and Group B. In Group A, we treated the patients with acupuncture, sweet bee venom treatment and FCST(Functional Cerebrospinal Therapy) through Standard intraoral appliance from ABA(Accurate Balancing Appliance), Full body exercise therapy, and Upper cervical alignment balance therapy. In Group B, we treated the patients with acupuncture and sweet bee venom treatment. To estimate the effectiveness in controlling pain, we analyzed the Visual analog scale(VAS). To evaluate functional change of patients, we analyzed the Oswestry low back disability questionnaire(ODI). Results : In both groups, VAS and ODI decreased significantly. In the VAS, the result of Group A is significantly more effective than that of Group B. In the ODI, the result of Group A is statistically less effective compared to that of Group B, but not significantly. Conclusions : According to the results, Postural Yinyang Correction of TMJ using Standard intraoral appliance may be effective treatment for low back pain, but the further researches are needed.

A Clinical Study of Spine Distortion and Self-conscious Pain in High School Students (청소년기(靑少年期)에서 척추체형(脊椎體形)과 자각증(自覺症)과의 임상적(臨床的) 고찰(考察))

  • Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.2
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    • pp.171-185
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    • 2002
  • Objectives : The purpose of this study was to investigate the spine distortion and self-conscious pain in high school students. Method : Using the phase-shifting moire developed by KAIST(Korea Advanced Institute of Science and Technology) we measured the back surface distortion, and using questionnaire investigation, we investigated the self-conscious pain in 30 high school students(17 boy students and 13 girl students). Results : This study show that low back pain was most cases, and next headache, upper back pain, abdominal pain, neck pain, shoulder pain, leg pain, chest pain and gluteal pain. The ratio of each self-conscious pain was 90.0%, 86.7%, 83.3%, 83.3%, 80.0%, 76.7%, 66.7%, 33.3%, 33.3%, 30.0%. In remainder value of left and right shoulder, above of 3.0 were three students., above 2.0 to bellow 3.0 were 10 students, bellow 2.0 were 17 students. In remainder value of left and right gluteal, above of 2.0 was one students, above 1.0 to bellow 2.0 were 18 students, bellow 1.0 were 10 students. In remainder value of cervical vertical line to left and right axillae, above 4.0 was 1 student, above 3.0 to bellow 2.0 were 2 students, above 2.0 to bellow 3.0 were 3 students, above 1.0 to bellow 2.0 were 16 students, bellow 1.0 were 7 students. In remainder value of gluteal vertical line to left and right axillae, above 6.0 was 1 student, above 5.0 to bellow 6.0 were 7 students, above 4.0 to bellow 5.0 were 3 students, above 3.0 to bellow 4.0 were 2 students, above 2.0 to bellow 3.0 were 5 students, above 1.0 to bellow 2.0 were 7 students, bellow 1.0 were 5 students. In remainder value of cervical vertical line to gluteal vertical line, above 40 was 1 student, above 3.0 to bellow 4.0 were 4 students, above 3.0 to bellow 3.0 were 6 students, above 1.0 to bellow 2.0 were 8 students, bellow 1.0 were 11 students. Conclusion : It is suggested that the significant correlation exist between the spinal distortion and self-conscious pain. And we can find many cases as spinal distortion in high school students also. We have to study further more about juvenile postural distortion and it's prevention.

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