• Journal of Korean Medicine Rehabilitation
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• v.30 no.4
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• pp.143-154
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• 2020

Objectives To analyze the prognosis of patients with low back pain according to the severity of abnormal lumbar lordotic angle and Ferguson's angle. Methods Data from electronic medical record of a total of 199 patients hospitalized in Korean medicine hospital were analyzed. With the sagittal view of lumbar spine X-ray, lumbar lordotic angle was defined as the angle between the superior endplate of L1 with the inferior endplate of L5. Ferguson's angle was defined as the angle between the superior surfaces of the sacral with a horizontal line. 'Measure Cobb's Angle Tool' of 'INFINITT PACS' was used to measure both angles. Lumbar lordotic angle and Ferguson's angle were subdivided into five sections. The number of days from onset and the duration of hospitalization were analyzed in each section. Results Severe hypolordotic lumbar lordotic angle group were found to have longer medical history and hospitalization duration than the control group. The ratio of long-term hospitalization (over 15 days) and chronic medical history (over 180 days) of patients with severe hypolordotic Ferguson's angle were significantly higher than the control group. The ratio of patients with chronic medical history (over 180 days) was significantly higher in severe hyperlordotic Ferguson's angle group than the control group. Conclusions Severe hypolordotic lumbar lordotic angle was related to patient's prognosis. Both severe hyperlordotic and severe hypolordotic Ferguson's angle were found to be related to patient's prognosis. However, a moderate loss of lumbar lordotic angle and Ferguson's angle was not related to prognosis of low back pain patients.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.283-293
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• 2021

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.571-576
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• 2013

The purpose of this study is to investigate work related diseases in Korean firefighters and to prepare the preventive measure for health management for the firefighters. Structured self-reported questionnaire was distributed to the firefighters. The result revealed that 37.7% of fire fighters had chronic diseases and 12.3% had chronic low back pains. The affected parts included lumbar region(41.5%), shoulder(33.0%), and neck(23.6%). The affected parts caused physical pain and work discomfort for more than a month. A total of 54.1% firefighters visited to the hospital within a year. This results suggest that it is necessary to develop the health promotion program for the prevention of musculoskeletal disease and regular health checkup for the acute disorders caused by workload.

• The Korean Journal of Pain
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• v.32 no.4
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• pp.280-285
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• 2019

Background: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. Methods: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. Results: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. Conclusions: The analgesic efficacy of PRF treatment did not differ with the needle tip position.

• The Journal of Internal Korean Medicine
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• v.15 no.2
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• pp.318-346
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• 1994

A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

• Physical Therapy Rehabilitation Science
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• v.8 no.3
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• pp.125-133
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• 2019

Objective: To compare the postural control between non-specific chronic low back pain (NSCLBP) subgroups and healthy people during dynamic balance performance using a modified Star Excursion Balance Test (mSEBT). Design: Cross-sectional study. Methods: Eighteen NSCLBP subjects (9 active extension pattern [AEP], 9 flexion pattern [FP]), and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg on a force plate. Normalized reach distance and balance parameters, including the center of pressure (COP) displacement and velocity, were recorded. Results: There were significant differences in mean reach distances in both posterolateral and posteromedial (PM) reach directions between AEP and healthy subjects (p<0.001) and between FP and healthy subjects (p<0.001). However, there were no significant differences among the three groups in the anterior reach direction. Also, the results showed no significant differences in mean COP variables (velocity and displacement) between pooled NSCLBP and healthy subjects. However, the subjects were reclassified into AEP, FP and healthy groups and the results showed a significant difference in mean COP velocity in the PM direction between AEP and FP subjects (p=0.048), and between AEP and healthy subjects (p=0.024). Conclusions: The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience deficits in dynamic postural control compared to healthy controls. In addition, the findings of this study support the concept of the Multidimensional Classification System.

• Physical Therapy Korea
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• v.12 no.2
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• pp.44-57
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• 2005

The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.1
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• pp.118-123
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• 2013

This study was performed from April, 2007 to August, 2012 with female patients who were being treated for and suffering from chronic lumbar pain for periods of 6 months and over. The 53 female patients were diagnosed with osteoporosis by having a T-Score of <-2.5 in a bone mineral density(BMD), as well as showing signs of metabolic syndrome. This was deduced by taking measurements of blood pressure, carrying out blood-chemical examinations and physical measurements such as weight, height, waist measurement and body mass index(BMI). After 5 minutes rest, the patient's blood pressure, height and weight were measured. BMI was calculated using the equation BMI = weight (Kg)/height ($m^2$). The patients had their blood taken in a fasted state(more than 12hours), the fasting blood sugar, total cholesterol, triglyceride, HDL-cholesterol were measured. The average BMD and T-score were calculated by measuring BMD(mg/cc) of L1-L3 using QCT. In a correlation analysis of the physical examinations, clinical character of metabolic syndrome and T-score, the result showed that age and T-score had a negative correlation(r=-0.699, p<0.01) as did triglyceride and T-score (r=-0.047, p<0.01), where as weight(r=0.239, p<0.05) and height(r-=0.329, p<0.01) and T-score had a positive correlation. There was no significant correlation with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score. This study showed that there are significant correlations with age, weight, height and T-score. But there are no significant correlations with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score and that these did not influence bone density. Further research with more subjects is required to determine whether there is a correlation of clinical character of metabolic syndrome and T-score.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.175-179
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• 2018

Study Design: Case report. Objectives: We report 3 cases of loss of disc height after spontaneous regression of a herniated lumbar disc. Summary of Literature Review: Reports of spontaneous regression of a herniated lumbar disc were identified. Materials and Methods: We conservatively treated 3 patients who were diagnosed with a herniated lumbar disc. During outpatient follow-up, radiating pain improved in all patients, but they complained of chronic lower back pain. Magnetic resonance imaging (MRI) was performed for diagnostic purposes. Results: On MRI, spontaneous regression of the herniated lumbar discs was observed, but loss of disc height was also found. Conclusions: A herniated lumbar disc may be a risk factor for loss of disc height. It is important to recognize that a patient with a herniated lumbar disc can struggle with chronic lower back pain even if spontaneous regression of the herniated lumbar disc occurs.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.