• Title/Summary/Keyword: acute low back pain

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요통 환자의 심박변이도 특성에 대한 임상적 연구 (Clinical Study for Characteristics of Heart Rate Variability in Low Back Pain Patients)

  • 류지미;김성수;정석희
    • 한방재활의학과학회지
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    • 제19권2호
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    • pp.241-250
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    • 2009
  • Objectives : To study autonomic nervous system dysfunction of Low Back Pain(LBP) patients, using spectral analysis of Heart Rate Variability(HRV). Methods : HRV of 190 patients was measured and seperated into two groups, those with LBP(n=95) and healthy controls(n=95). HRV was measured by SA-6000(Medicore, Korea) for 5 minutes after 5 minutes' resting. Results : 1. Mean heart rate(MHRT) of the experimental group was slightly higher than that of the control group, but did not show significant difference(P=0.428). The square root of the mean squared differences of successive normal-to-normal intervals(RMSSD), logarithmic very low frequency power(Ln VLF) and low frequency power/high frequency power ratio(LH/HF ratio) were not significantly low between experimental group and control group(P=0.16, 0.130, 0.537). 2. The standard deviation of all the normal-to-normal intervals(SDNN), logarithmic total power(Ln TP), logarithmic low frequency power(Ln LF) and logarithmic high frequency power(Ln HF) were significantly low between experimental group and control group(P=0.03, 0.005, 0.001, 0.007). 3. Ln LF of acute group was significantly low compared with those of chronic group(P= 0.039). Conclusions : This study suggests the activity and imbalance of autonomic nervous system in LBP is low. Also sympathetic nervous system of acute LBP is lower than that of chronic LBP. Further study of HRV related to LBP is needed in the clinical medicine.

Quebec Serve and Protect Low Back Pain Study: What About Mental Quality of Life?

  • Douma, Nabiha Benyamina;Cote, Charles;Lacasse, Anais
    • Safety and Health at Work
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    • 제10권1호
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    • pp.39-46
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    • 2019
  • Background: As of now, the impact of low back pain (LBP) and its chronic state, chronic low back pain (CLBP), on mental health-related quality of life (HRQOL) has never been investigated among police officers. The present investigation aims at studying this relationship using a biopsychosocial model. Methods: Between May and October 2014, a Web-based cross-sectional study was conducted among Quebec police officers (Quebec, Canada). Mental HRQOL was measured using the role emotional (RE) and the mental health (MH) domains of the SF-12v2 Health Survey. The impact of CLBP on mental HRQOL (as opposed to acute/subacute LBP or no LBP) was studied with a multivariate linear regression model. Results: Of the 3,589 police officers who participated in the study, 1,013 (28.4%) reported CLBP. The mean age of respondents was $38.5{\pm}8.7years$, and 32.0% were females. The RE (44.1/100) and MH (49.0/100) mean scores of the CLBP group were comparable with the scores found in populations suffering from cancer or heart diseases. Compared to officers without LBP, the presence of CLBP was significantly associated with lower RE (${\beta}$: -0.068; p = 0.003) and MH (${\beta}$: -0.062; p = 0.002) scores. These relationships were not found in the acute/subacute LBP group. Conclusion: Our results underscore how frequent CLBP is among police officers and how burdensome it is. Considering the importance of good physical and mental health for this occupational population, police organizations should be aware of this issue and contribute to the efforts toward CLBP prevention and management in the workplace.

급성 및 만성 요통환자의 요부주위근 횡단면적과 요통 예후의 상관관계 연구 (The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients)

  • 남지환;이종환;이슬지;김기원;이민정;전재윤;임수진;홍남중;송주현
    • Journal of Acupuncture Research
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    • 제30권4호
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    • pp.45-53
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    • 2013
  • Objectives : The purpose of this study was to evaluate the relationship between cross-sectional areas of the paraspinal and psoas muscles with low back pain. Methods : We assessed the cross-sectional area of the psoas and paraspinal muscles at the superior part of L4 level and vertebral body of L4 of 132 patients who were hospitalized with a chief complaint of low back pain at Jaseng Hospital of Korean Medicine from January 2013 to April 2013. After calculating the mean psoas area, we divided the patients into 2 groups by whether the psoas cross section was larger or smaller than the mean, and compared the admission period, verbal numeric rating scale(NRS) of low back pain(LBP), and improvement of verbal NRS of LBP. We also subcategorized the patients into acute and chronic groups according to the duration period, and compared the cross-sectional area of the psoas and paraspinal muscles. Results : Although analyses of the verbal NRS of LBP, and improvement of verbal NRS of LBP between groups with larger and smaller psoas cross section areas showed no significant difference, the admission period was significantly shorter in the group with larger psoas cross section areas. There was no significant difference in analyses of cross section areas in the acute and chronic groups. Of the possible prognostic variables, improvement of verbal NRS of LBP showed no correlation, while the admission period displayed a significant correlation. The cross-sectional area of the psoas and paraspinal muscles divided by the area of the vertebral body of L4 had a significant negative correlation with age. Conclusions : The cross-sectional area of the psoas and paraspinal muscles were correlated with the admission period in LBP patients, and the cross-sectional area of the surrounding muscles divided by the area of the L4 vertebral body was negatively correlated with age.

만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서 (Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases)

  • 장상범
    • Annals of Clinical Neurophysiology
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    • 제12권1호
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

만성통증환자의 심박변이도(Heart Rate Variability) 분석을 통한 자율신경계 특징에 관한 연구 (Analysis of Autonomic Nerve System by Analyzing the Herat Rate Variability(HRV) in Chronic Musculoskeletal Pain)

  • 하선윤;김동민;조성연;임인환;김용석;남상수
    • Journal of Acupuncture Research
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    • 제25권6호
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    • pp.35-46
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    • 2008
  • Objectives : Chronic pain affects and is affected by physical and psychosocial factors. It also has a complicated and indefinite mechanism. This research is for clarifying relations with chronic pain, stress, and autonomic nerve system by comparing HRV and Stress Reaction Index(SRI) of chronic pain patients with those of acute pain patients. Methods : The subjects were 32 patients who visited Kangnam Kyunghee Hospital for nuchal pain or low back pain treatment from March 2008 to September 2008. Among them, 16 patients who suffered over 6 months are classified chronic pain group and 16 patients who suffered under 6 months as acute pain group. All subjects had their HRV(SA-2000E: Medicore Co..Ltd. Korea) and SRI measured at first visit. We studied the difference of HRV between two groups.(Statistics by Student t-test, p<0.05) Results : R-MSSD, TP, VLF, LF, HF and LF/HF ratio of the chronic pain group were significantly lower than those of the acute pain group. Compared with those of the acute pain group, total SRI of the chronic pain group were low but it's not significant except frustration. Conclusion : The results of HRV of the chronic pain group patients show that chronic pain is related to psychosocial factor and autonomic disturbance.

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급성 천장골관절 염좌에 스테로이드 및 국소마취제의 관절내 주사 효과 (The Effects of Sacroiliac Injection of Local Anesthetics and Corticosteroids on Patients with Acute Sarcroiliac Sprain)

  • 신근만
    • The Korean Journal of Pain
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    • 제8권2호
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    • pp.293-297
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    • 1995
  • Despite applying recent advances in research and technology and taking into acount proper histories and performing thorough physical examinations, a high percentage of patients with low back pain have no identifiable pathology. Problems especially of the sacroiliac joint are commonly missed. The purpose of this article is to describe the effects of sacroiliac injection of local anesthetics and corticosteroids on patients with acute sacroiliac sprain. The sacroiliac joints are essentially nonweight-bearing joints that allows a small amount of anteroposterior rotatory movement around transverse axis usually about 5 to 10 cm below the promontory of the sacrum vertically. The ligamentous portion of sacroiliac joint is vulnerable to rotatory movement particularly when the individual is in an awkward position. Injections of 3 ml of 2% lidocaine and 10 mg of methylprednisolone were given twice at two day intervals to 26 patients with acute sacroiliac sprain. Most of those patients obtained excellent results without any adverse effects.

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요통을 가진 남성 제조업 근로자에 대한 수지 뜸 요법과 압봉자극법 적용 효과 (Effects of Hand Moxibustion and Hand Press Pellet on Low Back Pain, Range of Joint Movement, and Depression)

  • 김연옥;최순옥;김지원
    • 지역사회간호학회지
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    • 제30권3호
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    • pp.336-344
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    • 2019
  • Purpose: This study tries to examine the effects of hand moxibustion and press pellet by applying them to male manufacturing workers with low back pain, and use them to develop nursing interventions for workers. Methods: The data were collected from August to October, 2018, and the subjects were 60 men, processed by using SPSS/WIN 21.0 to perform homogeneity test with $x^2$-, t-, and hypothesis tests with repeated measures, ANOVA and $Scheff{\acute{e}}$ test. Results: Hypothesis 1 that "the experimental group provided with hand moxibustion and hand press pellet would give lower scores for low back pain than the control group" was supported (F=78.71, p<.001). Hypothesis 2 that "the experimental group provided with hand moxibustion and hand press pellet would have a wider range of motion than the control group" was also supported (F=17.44, p<.001). Hypothesis 3 that "the experimental group provided with hand moxibustion and hand press pellet would give lower scores for depression than the control group," again, was supported (F=16.95, p<.001). Conclusion: Hand moxibustion and hand press pellet are effective in relieving low back pain for male workers, in increasing the range of motion, and in decreasing depression.

경막외강내 스테로이드 투여후 관찰된 혈중 Prolactin 증가와 유즙 분비 -증례 보고- (Hyperprolactinemia and Galactorrhea Following Single Epidural Steroid Injection)

  • 원석규;전용석;석민호;심재철
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.150-154
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    • 1998
  • Epidural steroid injection have become one of the most frequently applied conservative option for the management of acute and chronic back pain. As the indications for epidural steroid injections increase so do the adverse responses associated with this procedure. This study reports the succession of 3 patients who developed galactorrhea and hyperprolactinemia after recieving an epidural steroid injection for lumbar radiculopathy and low back pain. Serum prolactin level was elevated in accordance with epidural injection of corticosteroid. We measured the serum prolactin level by immunoradiometric assay method and peak serum prolactin level at above 500, 144.2, 150.3 ng/ml respectively. Also we found the serum prolactin level decreased to normal values 3 wks after corticosteroid injection. Galactorrhra ceased in advance of decrease of serum prolactin level. That "Hyperprolactinemia and galactorrhea can occur following epidural steroid injection", requires a much larger prospective investigation.

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요부 안정화 운동이 급성기 요통 경감에 미치는 영향 (The Effect of Lumbar Stabilization Exercises on an Acute Lower Back Pain Reduction)

  • 강경화;김동욱;김미정;문현주;박영희;박성덕;김선엽
    • 대한정형도수물리치료학회지
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    • 제10권1호
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    • pp.67-81
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    • 2004
  • The purpose of this study was to investigate between low back pain scale and disability index owing to gait pattern. For the period of February 1 to February 29, 2004, we had conducted a questionnaire and direct interview with 100 persons lived in Daejeon. The result were as follows: 1. The stride length of experimental group, the male was $49.9{\pm}12.9cm$, the female $45.7{\pm}12.9cm$ and the width of feet. the male was $13.5{\pm}5.7cm$, the female $12.2{\pm}4.8cm$. 2. The Fick angle of all subjects was showed in external disposition, the left angle showed in asymmetry, the male was $11.0{\pm}5.7^{\circ}$, the female $8.5{\pm}1.3^{\circ}$. 3. The foot arch was similar to sex as a weight bearing and non-weight bearing, the male was $1.3{\pm}0.8cm$, the female $1.3{\pm}0.9cm$. 4. The impedimental index according to back pain grade, men was a lower than women, the male was $5.7{\pm}6.9$ and the female $7.2{\pm}5.3$. 5. The relation to difference between foot arch and disability index according to back pain grade as a weight bearing and non-weight bearing, the higher foot arch, the higher back pain grade was statistically significance(p<.05). 6. The relation between width of feet and disability index according to back pain grade, the wider width of feet, the higher back pain grade was statistically significance(p<.01). 7. The relation between stride length and disability index according to back pain grade, the wider stride length, the higher back pain grade was statistically significance (p<.05).

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비급성 요통에 대한 위수혈 자락관법의 효과 탐색: 예비 무작위 대조군 시험 (An Investigation on the Effects of Wet Cupping on Wisu (BL21) for Non-acute Low Back Pain: A Pilot Randomized Controlled Trial)

  • 김형석;조재흥;김고운;정원석;박재현;신우철;정석희
    • 한방재활의학과학회지
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    • 제28권4호
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    • pp.21-32
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    • 2018
  • Objectives This study was designed to investigate the effects of wet cupping on Wisu (BL12) in non-acute low back pain patients. Methods We recruited 30 participants for this study. Fifteen patients were randomly assigned to the Wisu (BL21) treatment group (WT group) and 15 were assigned to the non-acupoint treatment group (NT group). Both groups were treated with the pricking-cupping bloodletting method three times. Values at baseline and follow-up were analyzed by Wilcoxon signed rank test and the differences between the two groups were determined by Wilcoxon rank sum test. p-values less than 0.05 were considered significant. The primary outcome was the visual analogue scale (VAS), and secondary outcomes were the Oswestry disability index (ODI), Rolland-Morris disability questionnaire (RMDQ), Euroqol-5 dimension questionnaire (EQ-5D) and finger-to-ground distance (FTGD). These outcomes were measured on the day of first treatment before the procedure and on follow-up 7 days after the last treatment. Results Significant changes were identified in the VAS for pain and ODI in each group after wet cupping treatment on Wisu (p<0.05). However, no significant changes were found between groups. Meanwhile, RMDQ and EQ-5D were significantly decreased only in the NT group (p<0.05) without any differences between groups. FTGD was decreased in both groups, but not significantly. Conclusions Wet cupping with both Wisu treatment and non-acupoint had significant effects on non-acute low back pain, although there were no differences between the two groups. A large-scale study is needed to identify the effect of wet cupping on Wisu.